Sample records for intrastromal corneal ring

  1. Corneal asphericity in eye bank eyes implanted with the intrastromal corneal ring. (United States)

    Burris, T E; Holmes-Higgin, D K; Silvestrini, T A; Scholl, J A; Proudfoot, R A; Baker, P C


    To evaluate the effects of the intrastromal corneal ring, a device developed to reduce myopia, on corneal asphericity in a large set of eye bank eyes. Forty-one deturgesced eye bank eyes were implanted with intrastromal corneal rings of five different thicknesses, ranging from 0.25 mm to 0.45 mm. Corneal asphericity, before and after implantation, was examined using two different metrologies. Corneal asphericity profiles were produced from dioptric power data collected from videokeratography. To statistically assess the corneal asphericity differences between exam times for each intrastromal corneal ring thickness, dependent sample confidence intervals (95%) were calculated for the mean differences between preoperative and postoperative measures for each topographic diameter zone. Laser holographic interferometry was used to inspect corneal asphericity in one eye bank eye case study for four intrastromal corneal ring sizes. Wave unit map and geometric zonal spot ray tracing analyses derived from laser holographic interferometry topography were surveyed. Videokeratographic analysis suggested that preoperative corneal shape was prolate, i.e., flattened from central to paracentral cornea. Corneal shape became more prolate with intrastromal corneal ring implantation for all intrastromal corneal ring thicknesses. Laser holographic interferometry demonstrated that prolate asphericity was preserved with the intrastromal corneal ring sizes tested and that optical collection efficiency of the cornea was not diminished. Using two different measurement techniques, this eye bank eye study demonstrated that intrastromal corneal rings maintain prolate corneal asphericity.

  2. Surgical technique: coupling of intrastromal corneal ring segments for ectatic corneal disorders in eye bank corneas

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    Moshirfar M


    Full Text Available Majid Moshirfar1 Maylon Hsu1 Yousuf M Khalifa21Moran Eye Center, Salt Lake City, UT, 2Flaum Eye Institute, Rochester, NY, USAAbstract: The management of corneal ectasia is evolving, with intrastromal corneal ring segments playing an important role in delaying or eliminating the need for penetrating keratoplasty. This paper describes a modification in the implantation technique of intrastromal corneal ring segments that allows for coupling of the two segments with suture, affording more structural support.Keywords: intrastromal corneal ring segments, Intacs, keratonconus, corneal ectasia, keratoectasia

  3. Intrastromal corneal ring segment implantation for ectasia after refractive surgery. (United States)

    Torquetti, Leonardo; Ferrara, Paulo


    To evaluate the clinical outcomes of implantation of Ferrara intrastromal corneal ring segments (ICRS) in patients with corneal ectasia after refractive surgery. Private clinic, Belo Horizonte, Brazil. Charts of patients with corneal ectasia after refractive surgery were retrospectively reviewed. The following parameters were studied: uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal asphericity, and pachymetry. All patients were evaluated by Scheimpflug scanning-slit tomography (Pentacam). Twenty-five eyes (20 patients) with corneal ectasia (20 after laser in situ keratomileusis, 4 after radial keratotomy, 1 after photorefractive keratectomy) were evaluated. Postoperatively, the mean UDVA increased from 20/185 to 20/66 (P = .005) and the mean CDVA, from 20/125 to 20/40 (P = .008). The mean asphericity decreased from -0.95 preoperatively to -0.23 postoperatively (P = .006). The mean pachymetry at the apex of the cornea increased from 457.7 microm +/- 48.7 (SD) preoperatively to 466.2 +/- 49.8 mum postoperatively (P = .025) and the mean pachymetry at the thinnest point, from 436.3 +/- 46.2 microm to 453.9 +/- 49.3 microm (P = .000). The mean keratometry decreased from 45.41 +/- 5.63 diopters (D) to 42.88 +/- 4.44 D, respectively; the decrease was statistically significant (P = .000). Intrastromal corneal ring segment implantation significantly improved UDVA and CDVA in patients with corneal ectasia. (c) 2010. Published by Elsevier Inc.

  4. Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking


    Lam, Kay; Rootman, Dan B.; Lichtinger,, Alejandro; Rootman, David S.


    Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure–lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking. Vision improved and the ectasia stabilized following treatment. Combined ICRS implantation and collagen cross-...

  5. Intrastromal corneal ring segments for management of keratoconus

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    Sri Ganesh


    Full Text Available Keratoconus is a progressive corneal ectasia, which can be managed both by conservative measures like glasses or contact lenses in non-progressive cases or surgical procedures like collagen crosslinking (CXL with or without adjuvant measures like intrastromal corneal rings segments (ICRS or topography guided ablation. Various kinds of ICRS are available to the surgeon, but it is most essential to be able to plan the implantation of the ring to optimize outcomes. Aims: The aim of this study is to evaluate the visual outcome and progression in patients of keratoconus implanted with ICRS. Materials and Methods: Two different types of ICRS-Intacs (Addition Technology and Kerarings (Mediphacos Inc. were implanted in 2 different cohorts of patients and were followed-up to evaluate the outcome of the procedure. All patients underwent a complete ocular examination including best spectacle corrected visual acuity, slit lamp examination fundus examination, corneal topography and pachymetry. The ICRS implantation is done with CXL to stop the progression of the disease. Improvement in uncorrected visual acuity (UCVA, best spectacle corrected visual acuity and topographic changes were analyzed. Results: A significant improvement in keratometry and vision was seen in both groups. Conclusion: ICRS have been found to reduce corneal irregularity and flatten keratometry with improvement in UCVA and best corrected visual acuity.

  6. Post-LASIK ectasia treated with intrastromal corneal ring segments and corneal crosslinking. (United States)

    Lam, Kay; Rootman, Dan B; Lichtinger, Alejandro; Rootman, David S


    Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure-lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking. Vision improved and the ectasia stabilized following treatment. Combined ICRS implantation and collagen cross-linking should be considered early in the management of post-LASIK ectasia.

  7. Recent advances in the treatment of corneal ectasia with intrastromal corneal ring segments. (United States)

    Poulsen, David M; Kang, Joann J


    To review the recent advances and reported outcomes in the use of intrastromal corneal ring segments (ICRS) for the treatment of corneal ectasia. ICRS are a well-tolerated and effective treatment for patients with corneal ectasia, particularly keratoconus, offering long-term improvement in visual, refractive, and keratometric measures. ICRS do not consistently decrease corneal aberrations. Patients with mild-to-moderate keratoconus, known to have less predictable outcomes with ICRS, may be better selected and treated with the use of customized nomograms, accounting for factors such as internal astigmatism. Corneal collagen cross-linking performed after ICRS implantation is an important complementary treatment in preventing the progression of ectasia, whereas subsequent treatment with either photorefractive keratectomy or toric intraocular lens implantation offers a significantly improved visual and refractive result. ICRS are an important component to the treatment of corneal ectasia. Knowledge of outcomes among specific groups of patients should improve treatment planning and nomograms. Combined treatments with ICRS allow for notable improvements in corneal stability and refractive error, in addition to the improvement in irregular astigmatism seen with ICRS.

  8. Evolution in the use of intrastromal corneal ring segments for corneal ectasia. (United States)

    Park, Jennifer; Gritz, David C


    To report the recent advances in the use of intrastromal corneal ring segments (ICRS) for treating patients with corneal ectasia. ICRS improve visual, refractive, and keratometric parameters in patients with keratoconus and postlaser in-situ keratomileusis ectasia. ICRS have been made safer, quicker, and more precise with the use of femtosecond lasers for ring insertion. ICRS produce better visual outcomes in patients with poor preoperative corrected distance visual acuity compared with patients with less preoperative visual impairment. Standard ICRS do not improve vision in patients with stage 3-4 keratoconus (Amsler-Krumeich classification), but newer models of ICRS, such as Intacs SK, appear promising for these patients. ICRS have been successfully combined with treatments such as corneal collagen cross-linking (CXL), penetrating keratoplasty, and photorefractive keratectomy. ICRS variably improve visual acuity. Numerous questions concerning ICRS remain, including the duration of the effects of ICRS and the changes that ICRS induce on a biomechanical level. The optimal method for combined CXL and ICRS placement has not yet been determined. Further well-designed randomized controlled studies with long-term follow-up are needed for clarification.

  9. Intrastromal corneal ring implants for corneal thinning disorders: an evidence-based analysis. (United States)


    surgeons in selecting ring segment size, number and position. Generally, two segments of equal thickness are placed superiorly and inferiorly to manage symmetrical patterns of corneal thinning whereas one segment may be placed to manage asymmetric thinning patterns. Following implantation, the major safety concerns are for potential adverse events including corneal perforation, infection, corneal infiltrates, corneal neovascularization, ring migration and extrusion and corneal thinning. Technical results can be unsatisfactory for several reasons. Treatment may result in an over or under-correction of refraction and may induce astigmatism or asymmetry of the cornea. Progression of the corneal cone with corneal opacities is also invariably an indication for progression to corneal transplant. Other reasons for treatment failure or patient dissatisfaction include foreign body sensation, unsatisfactory visual quality with symptoms such as double vision, fluctuating vision, poor night vision or visual side effects related to ring edge or induced or unresolved astigmatism. The literature search strategy employed keywords and subject headings to capture the concepts of 1) intrastromal corneal rings and 2) corneal diseases, with a focus on keratoconus, astigmatism, and corneal ectasia. The initial search was run on April 17, 2008, and a final search was run on March 6, 2009 in the following databases: Ovid MEDLINE (1996 to February Week 4 2009), OVID MEDLINE In-Process and Other Non-Indexed Citations, EMBASE (1980 to 2009 Week 10), OVID Cochrane Library, and the Centre for Reviews and Dissemination/International Agency for Health Technology Assessment. Parallel search strategies were developed for the remaining databases. Search results were limited to human and English-language published between January 2000 and April 17, 2008. The resulting citations were downloaded into Reference Manager, v.11 (ISI Researchsoft, Thomson Scientific, U.S.A), and duplicates were removed. The Web

  10. Indications for intrastromal corneal ring segments in ectasia after laser in situ keratomileusis. (United States)

    Brenner, Luis F; Alió, Jorge L; Vega-Estrada, Alfredo; Baviera, Julio; Beltrán, Jaime; Cobo-Soriano, Rosario


    To evaluate clinical results of intrastromal corneal ring segments (ICRS) in a large series of post-laser in situ keratomileusis (LASIK) ectasia and determine which clinical parameters were related to the success of this technique. Vissum Corporation and Clínica Baviera Group, Alicante, Spain. Case series. Intrastromal corneal ring segments were implanted to correct the spherocylindrical error and improve visual acuity. Based on a previously described grading system, the best indications for ICRS implantation to treat post-LASIK ectasia were evaluated. The variables related to favorable outcomes over a 12-month follow-up were determined. Patients who lost 2 or more lines due to post-LASIK ectasia had a mean gain of +2.89 lines of corrected distance visual acuity (CDVA) after ICRS implantation (Pectasia had a mean loss of -2.00 lines of CDVA after the ICRS implantation (Pectasia. The best indications for ICRS were a loss of 2 or more lines of CDVA after ectasia and post-LASIK ectasia grade 4. Patients who do not have vision loss after ectasia and those classified as grade 1 should not be considered candidates for ICRS implantation. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Long-term outcomes of intrastromal corneal ring segment implantation for post-LASIK ectasia. (United States)

    Yildirim, Aydin; Cakir, Hanefi; Kara, Necip; Uslu, Hasim


    To report the long-term results of intrastromal corneal ring segments (ICRS) for postoperative LASIK ectasia. In this retrospective interventional cases series, 8 eyes of 6 patients who underwent femtosecond laser-assisted ICRS implantation for post-LASIK ectasia were enrolled. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, and average keratometry (Kavg) values were assessed. Mean±SD follow-up was 67±21 months (range, 36-96 months). The mean UDVA, CDVA, spherical equivalent refraction, and Kavg values were significantly improved at all postoperative visits when compared to baseline values. No serious complications were observed during follow-up. Our long-term findings showed that ICRS yielded improvements in visual acuity, refractive status, and keratometric values without any progression in cases with post-LASIK corneal ectasia. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Femtosecond-assisted intrastromal corneal ring implantation for keratoconus treatment: a comparison with crosslinking combination

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    Peter Alexander von Harbach Ferenczy


    Full Text Available Purpose: To compare visual outcomes, corneal astigmatism, and keratometric readings in patients with keratoconus who underwent intrastromal corneal ring implantation (ICRSI alone with those who underwent ICRSI combined with ultraviolet A riboflavin-mediated corneal collagen crosslinking (CXL. Methods: Pre- and post-operative best-corrected distance visual acuity (BCDVA, spherical error, cylindrical error, and mean keratometry were retrospectively compared over a period of 2 years in patients with keratoconus who underwent only ICRSI (group 1 versus those in patients who underwent combined ICRSI-CXL (group 2. Results: Thirty-two eyes of 31 patients were evaluated. CXL was performed in 10 cases (31%, and there were no complications or need for ring repositioning. BCDVA improved from 0.54 to 0.18 in the group 1 and from 0.56 to 0.17 in the group 2. Spherical and cylindrical errors and mean keratometry values significantly decreased in both groups. No patient postoperatively had visual acuity (VA of less than 20/60 on refraction, and 78% exhibited VA better than or equal to 20/40 with spectacles (72% of group 1 and 90% of group 2. Improvement in the spherical equivalent (SE value was observed in the group 1 (from -5.89 ± 3.37 preoperatively to -2.65 ± 2.65 postoperatively; p<0.05 and group 2 (from -6.91 ± 1.93 preoperatively to -2.11 ± 3.01 postoperatively; p<0.05. Conclusion: Both techniques can be considered safe and effective in improving VA and refractive SE values, in decreasing the curvature of the cone apex in the topographical analysis, and in decreasing corrected diopters postoperatively in patients with keratoconus.

  13. Evaluation of intrastromal corneal ring segments for treatment of keratoconus with a mechanical implantation technique

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    Zeki Tunc


    Full Text Available Purpose: To evaluate the clinical outcomes of intrastromal corneal ring segment (ICRS implantation in patients with keratoconus using a mechanical implantation technique. Materials and Methods: Thirty eyes of 17 patients with keratoconus were enrolled. ICRSs (Keraring were implanted after dissection of the tunnel using Tunc′s specially designed dissector under suction. A complete ophthalmic examination was performed, including uncorrected distance visual acuity (UDVA, corrected distance visual acuity (CDVA, spherical equivalent, keratometric readings, inferosuperior asymmetry index (ISAI, and ultrasound pachymetry. All 3-, 6-, and 12-month follow-ups were completed, and statistical analysis was performed. Results: The mean preoperative UDVA for all eyes was 1.36 ± 0.64 logMAR. At 12 months, the mean UDVA was 0.51 ± 0.28 logMAR (P = 0.001, and the mean preoperative CDVA was 0.57 ± 0.29 logMAR, which improved to 0.23 ± 0.18 (P = 0.001 at 1 year. There was a significant reduction in spherical equivalent refractive error from -6.42 ± 4.69 diopters (D preoperatively to -1.26 ± 1.45 D (P = 0.001 at 1 year. In the same period, the mean K-readings improved from 49.38 ± 3.72 D to 44.43 ± 3.13 D (P = 0.001, and the mean ISAI improved from 7.92 ± 3.12 to 4.21 ± 1.96 (P = 0.003. No significant changes in mean central corneal thickness were observed postoperatively. There were no major complications during and or after surgery. Conclusion: ICRS implantation using a unique mechanical dissection technique is a safe and effective treatment for keratoconus. All parameters improved by the 1-year follow-up.

  14. Scleral lenses in the treatment of post-LASIK ectasia and superficial neovascularization of intrastromal corneal ring segments. (United States)

    Kramer, Elise G; Boshnick, Edward L


    This case report aims to explore the use of scleral lenses for the treatment of ocular and visual complications in an adult patient presenting with post-LASIK (Laser-Assisted in situ Keratomileusis) ectasia in both eyes with cross-linking in the right eye and intrastromal corneal ring segments (ICRS; Intacs, Addition Technology, Fremont, CA) in the left eye. Following a comprehensive eye exam and specific testing for contact lens fitting, scleral lenses were fitted with success in both eyes and dispensed. Due to progressive fibrosis and neovascularization of the inferior ICRS in the left eye, the inferior ICRS was removed and scleral lenses were refit with success. Prescribed scleral lenses helped the patient achieve optimal visual correction (20/20) as well as ocular protection of the cornea. Post-LASIK ectasia is a common finding among contact lens specialists today. When ICRS surgery is involved, the fitting of contact lenses may become more challenging. Scleral lenses offer a unique way of addressing many issues raised in this case report including corneal neovascularization and ectasia. This lens modality may be considered for any other case involving irregular corneal curvature following surgery resulting in reduced visual acuity. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  15. Same-day intrastromal corneal ring segment and collagen cross-linking for ectasia after laser in situ keratomileusis: long-term results. (United States)

    Yildirim, Aydin; Uslu, Hasim; Kara, Necip; Cakir, Hanefi; Gurler, Bulent; Colak, Hatice Nur; Ozgurhan, Engin Bilge


    To report the long-term results of combined same-day intrastromal corneal ring segment placement and corneal collagen cross-linking (CXL) for postoperative laser in situ keratomileusis (LASIK) ectasia. Retrospective, interventional case series. This retrospective, interventional cases series was performed in Turkiye Hospital Eye Clinic and the Department of Ophthalmology, Fatih University Medical Faculty Hospital, Istanbul, Turkey. Sixteen eyes of 14 patients with postoperative ectasia after LASIK were enrolled. All consecutive patients were treated with femtosecond laser-assisted intrastromal corneal ring segment implantation and followed by same-day corneal collagen cross-linking for ectasia occurring after LASIK. Main outcome measures included uncorrected distance visual acuity, corrected distance visual acuity, spherical and cylindrical refraction, and simulated keratometry values. The mean age ± standard deviation of the 10 women and 4 men was 33.0 ± 6.5 years (range, 23 to 44 years), and the mean follow-up was 43 months (range, 36 to 62 months). The uncorrected distance visual acuity improved significantly from 1.18 ± 0.42 logarithm of the minimal angle of resolution (logMAR) units to 0.44 ± 0.22 logMAR (P corneal ring segment implantation combined with same-day corneal collagen cross-linking was a safe and effective treatment for ectasia occurring after LASIK. It also significantly improved the visual acuity, refraction, and keratometry values. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Corneal ectasia after intrastromal presbyopic surgery. (United States)

    Courjaret, Jean-Christophe; Matonti, Frederic; Savoldelli, Michele; D'Hermies, Francois; Legeais, Jean-Marc; Hoffart, Louis


    To report histopathologic findings in a case of bilateral corneal ectasia following intrastromal femtosecond laser presbyopia surgery. Case report. A 56-year-old patient was referred for bilateral corneal ectasia. He was treated for hyperopia using LASIK twice in both eyes. A bilateral femtosecond laser intrastromal presbyopia correction was secondarily performed. The patient complained of progressive loss of distance visual acuity shortly after. Corneal topography showed a bilateral central corneal protrusion. Rigid contact lenses were successfully fitted on the right eye and, because the patient still complained, a deep anterior lamellar keratoplasty was performed in the left eye. Light and electronic microscopy of the corneal button revealed that the inner intrastromal incision crossed the LASIK interface and led to stromal bed dehiscence. This case illustrates that intrastromal refractive surgery should not be recommended in eyes previously treated by lamellar refractive surgery.

  17. Extrusão do anel intra-estromal corneano e vascularização do túnel Extrusion and vascularization of the intrastromal corneal ring tunnel

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    Larissa Casteluber


    Full Text Available O objetivo deste trabalho é relatar e discutir os aspectos de um caso clínico em que foi observada a formação de neovascularização no túnel do anel intra-estromal corneano. Trata-se de paciente com ectasia corneana 4 anos após LASIK, comprovada pela paquimetria e topografia, e submetido ao implante de anel intra-estromal corneano. No terceiro ano de acompanhamento após implante do anel intraestromal, com o paciente em uso de lente de contato gelatinosa, verificou-se extrusão de um segmento e neovascularização no túnel. Removeu-se o segmento afetado, realizou-se fotocoagulação vascular, observando-se regressão completa do quadro neovascular.The purpose of this paper is to describe the clinical aspects of one case with deep corneal vascularization after corneal ring implantation to treat corneal ectasia due to LASIK 4 years before. The corneal ectasia diagnostic was performed by corneal pachimetry and topography. Intrastromal corneal ring segment was implanted. On the third year of follow-up, extrusion of one segment was noted and deep corneal neovascularization was found. The segment was removed, laser photocoagulation was applied and complete vascular regression was observed.

  18. Evaluation of intrastromal corneal ring segments for treatment of post-LASIK ectasia patients with a mechanical implantation technique (United States)

    Tunc, Zeki; Helvacioglu, Firat; Sencan, Sadik


    Aim: To evaluate the clinical outcomes of Keraring segment implantation in patients with post- laser-assisted in situ keratomileusis (LASIK) ectasia, using a mechanical implantation technique. Materials and Methods: Twelve eyes of 10 patients with post-LASIK ectasia were enrolled. Intracorneal ring segments (ICRS) were implanted after dissection of the tunnel using Tunc's specially designed dissector under suction. A complete ophthalmic examination was performed, including uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent, keratometric (K) readings, inferosuperior asymmetry index (ISAI), and ultrasound pachymetry. All 3, 6, and 12-month follow-ups were completed, and statistical analysis was performed. Results: The mean preoperative UDVA for all eyes was 1.28 ± 0.59 logMAR. At 12 months, the mean UDVA was 0.36 ± 0.19 logarithm of the Minimum Angle of Resolution (logMAR) (P=0.002), and the mean preoperative CDVA was 0.58 ± 0.3 logMAR, which improved to 0.15 ± 0.12 (P=0.002) at 1 year. There was a significant reduction in cylindrical refractive and spherical equivalent refractive error from –5.29 ± 2.47 diopters (D) and –5.54 ± 5.04 D preoperatively to –1.47 ± 0.71 D and –0.74 ± 1.07 D (P=0.001, P=0.002), respectively, at 1 year. In the same period, the mean K- readings improved from 47.93 ± 4.84 D to 40.87 ± 2.36 D (P=0.002), and the mean ISAI improved from 5.34 ± 3.05 to 2.37 ± 1.68 (P=0.003). No significant changes in mean central corneal thickness were observed postoperatively. There were no major complications during or after surgery. Conclusion: ICRS implantation using a unique mechanical dissection technique is a safe and effective treatment for post-LASIK ectasia. All parameters showed improvement at 1-year follow-up. PMID:22011487

  19. Intrastromal Delivery of Bevacizumab Using Microneedles to Treat Corneal Neovascularization (United States)

    Kim, Yoo C.; Grossniklaus, Hans E.; Edelhauser, Henry F.; Prausnitz, Mark R.


    Purpose. This study tested the hypothesis that highly targeted intrastromal delivery of bevacizumab using coated microneedles allows dramatic dose sparing compared with subconjunctival and topical delivery for treatment of corneal neovascularization. Methods. Stainless steel microneedles 400 μm in length were coated with bevacizumab. A silk suture was placed in the cornea approximately 1 mm from the limbus to induce corneal neovascularization in the eyes of New Zealand white rabbits that were divided into different groups: untreated, microneedle delivery, topical eye drop, and subconjunctival injection of bevacizumab. All drug treatments were initiated 4 days after suture placement and area of neovascularization was measured daily by digital photography for 18 days. Results. Eyes treated once with 4.4 μg bevacizumab using microneedles reduced neovascularization compared with untreated eyes by 44% (day 18). Eyes treated once with 2500 μg bevacizumab using subconjunctival injection gave similar results to microneedle-treated eyes. Eyes treated once with 4.4 μg subconjunctival bevacizumab showed no significant effect compared with untreated eyes. Eyes treated with 52,500 μg bevacizumab by eye drops three times per day for 14 days reduced the neovascularization area compared with untreated eyes by 6% (day 18), which was significantly less effective than the single microneedle treatment. Visual exam and histological analysis showed no observable effect of microneedle treatment on corneal transparency or microanatomical structure. Conclusions. This study shows that microneedles can target drug delivery to corneal stroma in a minimally invasive way and demonstrates effective suppression of corneal neovascularization after suture-induced injury using a much lower dose compared with conventional methods. PMID:25212779

  20. Apparent Corneal Ectasia After Bilateral Intrastromal Femtosecond Laser Treatment for Presbyopia. (United States)

    Dukic, Adrijana; Bohac, Maja; Pasalic, Adi; Koncarevic, Mateja; Anticic, Marija; Patel, Sudi


    To report a case of apparent corneal ectasia after intrastromal femtosecond laser treatment for presbyopia (INTRACOR). A healthy 56-year-old male with low hyperopia underwent an unremarkable bilateral INTRACOR procedure in March/April 2011. The patient was discharged after follow-up and returned 5 years later. Before discharge, the monocular logarithm of the minimal angle of resolution uncorrected distance visual acuity (UDVA) values were R, 0.0 and L, 0.10. In both eyes near (UNVA) visual acuities were 0.0. There were signs of slight posterior central corneal steepening without loss of corneal stability. Five years postop, monocular UDVA and UNVA values were 0.4 and 0.0, respectively. Ectasia was observed in both eyes, and the centrally placed 5 concentric rings after the INTRACOR procedure were visible under slit-lamp biomicroscopy. There is no clear reason to explain why the patient developed bilateral corneal steepening. It could be that the patient's corneal stromal fibers gradually weakened over this 5-year period.

  1. Intracorneal Ring Segments Implantation for Corneal Ectasia. (United States)

    Giacomin, Natalia T; Mello, Glauco R; Medeiros, Carla S; Kiliç, Alyin; Serpe, Cristine C; Almeida, Hirlana G; Kara-Junior, Newton; Santhiago, Marcony R


    To provide an overview of the predictability, safety, and efficacy of intrastromal corneal ring segment (ICRS) implantation as a tool to improve visual acuity and its association with other techniques such as corneal collagen cross-linking (CXL), addressing biomechanical outcomes, models, surgical planning and technique, indications, contraindications, and complications in ectatic corneas. Literature review. ICRSs have been used to regularize the corneal shape and reduce corneal astigmatism and higher order aberrations, improve visual acuity to acceptable limits, and delay, or eventually prevent, a corneal keratoplasty in keratoconic eyes. Changes in ICRS thickness and size, combination of techniques, and the addition of femtosecond lasers to dissect more foreseeable channels represent an improvement toward more predictable results. Several studies have shown, over time, the long-term efficacy and safety of ICRS treatment for keratoconus, with variable predictability, maintaining the early satisfactory outcomes regarding visual acuity, keratometry, and corneal thickness. It is just as important to ensure that the disease will not progress as it is to improve the visual acuity. Therefore, many studies have shown combined techniques using ICRS implantation and CXL. Also, further limitations of ICRS implantation can be addressed when associated with phakic intraocular lens implantation and photorefractive keratectomy. ICRS implantation has shown effectiveness and safety in most cases, including combined procedures. In properly selected eyes, it can improve both refraction and vision in patients with keratoconus. [J Refract Surg. 2016;32(12):829-839.]. Copyright 2016, SLACK Incorporated.

  2. Unilateral Keratectasia Treated with Femtosecond Fashioned Intrastromal Corneal Inlay (United States)

    Jadidi, Khosrow; Hasanpour, Hossein


    Purpose: In this case report, we describe the surgical procedure of corneal inlay preparation and corneal pocket creation using a femtosecond laser system. Case Report: A 7-year-old girl who presented with unilateral paracentral corneal thinning underwent the surgical procedure of corneal inlay. Preoperatively, the refraction was +10.00-6.00 × 170. One month after the procedure, astigmatism and hyperopia were decreased and the refraction was +5.00-1.25 × 110. Conclusion: Femtosecond laser–assisted pocket creation for the implantation of corneal inlays offers accuracy of pocket parameters, enhancing predictability, resulting in better final outcomes, and improving the safety of the procedure. PMID:28791068

  3. Unilateral keratectasia treated with femtosecond fashioned intrastromal corneal inlay

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    Khosrow Jadidi


    conclusion: Femtosecond laser–assisted pocket creation for the implantation of corneal inlays offers accuracy of pocket parameters, enhancing predictability, resulting in better final outcomes, and improving the safety of the procedure.

  4. A Novel Tectonic Keratoplasty with Femtosecond Laser Intrastromal Lenticule for Corneal Ulcer and Perforation. (United States)

    Jiang, Yang; Li, Ying; Liu, Xiao-Wei; Xu, Jing


    Small incision refractive lenticule extraction (SMILE) is an effective laser procedure that treats myopia. This research was to describe a novel approach to treat corneal ulcer or perforation using the corneal lenticules obtained from SMILE and to evaluate the safety and effectiveness of tectonic keratoplasty with femtosecond laser intrastromal lenticule (TEKIL). A total of twenty patients (22 eyes) were monitored for at least 6 months and were assessed using slit lamp microscopy, optical coherence tomography, and best-corrected visual acuity (BCVA). Postoperative complications throughout the study period were recorded. Corneal ulcer in 14 patients (16 eyes) and corneal perforation in six patients (6 eyes) were treated with TEKIL. The patients were ten females and ten males, with a mean age of 58.5 ± 16.3 years (range: 16-81 years). In this study, the most causes of corneal ulcer or perforation were immunologic causes (54.5%). After TEKIL procedure, global integrity was achieved in all cases. No immune rejection or perforation was detected. The mean BCVA improved from 0.17 ± 0.20 preoperatively to 0.27 ± 0.25 postoperatively at the final follow-up (t = 2.095, P = 0.052). The postoperative BCVA improved in 12 eyes (54.5%) and maintained in nine eyes (40.9%). Vision function successfully maintained in all eyes (100%). In three cases, corneal ulcers were treated by reoperation of TEKIL at 3 months after the initial surgery for the reason that the residual corneal thickness was corneal ulcer and perforation in the condition of emergency and donor shortage.

  5. Effectiveness of photodynamic therapy with verteporfin combined with intrastromal bevacizumab for corneal neovascularization in Stevens-Johnson syndrome. (United States)

    Yoon, Hyeon Jeong; Kim, Mee Kum; Seo, Kyung Yul; Ueta, Mayumi; Yoon, Kyung Chul


    To investigate the effectiveness of combined photodynamic therapy with verteporfin and intrastromal injection of bevacizumab for the treatment of corneal neovascularization in patients with Stevens-Johnson syndrome (SJS). Eight eyes of eight patients with SJS having corneal neovascularization who were refractory to 1% prednisolone instillation received photodynamic therapy with verteporfin (6 mg/m 2 ) combined with intrastromal bevacizumab injection (2.5 mg/0.1 mL). Best-corrected visual acuity and intraocular pressure were assessed, and slit-lamp biomicroscopic examination was performed before treatment and at 1 week and every month. A chronic ocular manifestation score was assigned based on the involvement area or the severity before treatment. The cumulative length of corneal blood vessels and area of corneal neovascularization were measured by anterior segment photographs before and after treatment. At 3 and 6 months after treatment, all eyes showed regression of corneal neovascularization. Complete regression was achieved in five eyes (62.5%) and partial regression in three eyes (37.5%). Among five patients who were followed up for more than 1 year, two eyes maintained complete regression and one eye maintained partial regression at 1 year. However, two eyes with severe chronic ocular manifestation showed revascularization. Combined photodynamic therapy with intrastromal bevacizumab injection can effectively inhibit corneal neovascularization in patients with SJS. However, patients with severe chronic ocular manifestation may exhibit revascularization.

  6. Rate of riboflavin diffusion from intrastromal channels before corneal crosslinking. (United States)

    McQuaid, Rebecca; Mrochen, Michael; Vohnsen, Brian


    To determine the diffusion of riboflavin from intrastromal channels through the effective diffusion coefficients compared with traditional axial diffusion with epithelium on or off. Advanced Optical Imaging Laboratory, University College Dublin, and Wellington Eye Clinic, Sandyford, Dublin, Ireland. Experimental study. The rate of diffusion in whole-mounted porcine eyes was monitored for a 30 minutes using an optical setup with a charge-coupled device camera and a bandpass filter (central wavelength 550 nm and 40 nm bandpass) to image the fluorescence under ultraviolet illumination (365 nm wavelength). For comparison, an isotropic corneal stroma with an annular channel was modeled numerically for different diffusion constants and boundary conditions. Numerical and experimental results were compared, allowing determination of the effective diffusion coefficient for each case. Experimental results for 6 different riboflavin solutions were in all cases found to be higher than for the common crosslinking (CXL) riboflavin protocol, where the diffusion constant is D0 = 6.5 × 10(-5) mm(2)/sec. For the intrastromal channel, 2 isotonic solutions containing riboflavin 0.1% correlated with a diffusion constant of 5D0 = 32.5 × 10(-5) mm(2)/sec. Hypotonic solutions and transepithelium had a higher diffusion coefficient approaching 10D0 = 65.0 × 10(-5) mm(2)/sec, which is an order-of-magnitude increase compared with the typical diffusion coefficient found in standard CXL. In this study, riboflavin had a faster stromal diffusion when injected into a corneal channel than when applied as drops to the anterior corneal surface. Further numerical modeling might allow optimization of the channel structure for any specific choice of riboflavin. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Corneal iron ring after hyperopic photorefractive keratectomy. (United States)

    Bilgihan, K; Akata, F; Gürelik, G; Adigüzel, U; Akpinar, M; Hasanreisoğlu, B


    To report the incidence and course of corneal iron deposition after hyperopic photorefractive keratectomy (PRK). Gazi University, Medical School, Department of Ophthalmology, Ankara, Turkey. Between January 1995 and December 1997, 62 eyes had PRK to correct hyperopia. Nine eyes developed corneal iron ring 5 to 8 months (mean 6.25 months +/- 1.3 [SD]) after PRK for hyperopia. The rings persisted during the mean follow-up of 19 +/- 11.09 months. The ring-shaped iron deposition after PRK for hyperopia must be differentiated from the Fleischer ring. Our results suggest that the slitlamp findings of peripheral corneal iron deposition in hyperopic PRK patients correlate with achieved correction.

  8. Experimental Models for Investigating Intra-Stromal Migration of Corneal Keratocytes, Fibroblasts and Myofibroblasts

    Directory of Open Access Journals (Sweden)

    Lisha Ma


    Full Text Available Following laser vision correction, corneal keratocytes must repopulate areas of cell loss by migrating through the intact corneal stroma, and this can impact corneal shape and transparency. In this study, we evaluate 3D culture models for simulating this process in vitro. Buttons (8 mm diameter were first punched out of keratocyte populated compressed collagen matrices, exposed to a 3 mm diameter freeze injury, and cultured in serum-free media (basal media or media supplemented with 10% FBS, TGFb1 or PDGF BB. Following freeze injury, a region of cell death was observed in the center of the constructs. Although cells readily migrated on top of the matrices to cover the wound area, a limited amount of cell migration was observed within the constructs. We next developed a novel “sandwich” model, which better mimics the native lamellar architecture of the cornea. Using this model, significant migration was observed under all conditions studied. In both models, cells in TGFb and 10% FBS developed stress fibers; whereas cells in PDGF were more dendritic. PDGF stimulated the most inter-lamellar migration in the sandwich construct. Overall, these models provide insights into the complex interplay between growth factors, cell mechanical phenotypes and the structural properties of the ECM.

  9. Corneal ring infiltration in contact lens wearers

    Directory of Open Access Journals (Sweden)

    Seyed Ali Tabatabaei


    Full Text Available To report a case of atypical sterile ring infiltrates during wearing soft silicone hydrogel contact lens due to poor lens care. A 29-year-old woman presented with complaints of pain, redness, and morning discharge. She was wearing soft silicone hydrogel contact lens previously; her current symptoms began 1 week before presentation. On examination, best-corrected visual acuity was 20/40 in that eye. Slit-lamp examination revealed dense, ring-shaped infiltrate involving both the superficial and deep stromal layers with lucid interval to the limbus, edema of the epithelium, epithelial defect, and vascularization of the superior limbus. Cornea-specific in vivo laser confocal microscopy (Heidelberg Retina Tomograph 2 Rostock Cornea Module, HRT 2-RCM, Heidelberg Engineering GmbH, Dossenheim, Germany revealed Langerhans cells and no sign of Acanthamoeba or fungal features, using lid scraping and anti-inflammatory drops; her vision completely recovered. We reported an atypical case of a sterile corneal ring infiltrate associated with soft contact lens wearing; smear, culture, and confocal microscopy confirmed a sterile inflammatory reaction.

  10. Reshaping procedures for the surgical management of corneal ectasia. (United States)

    Ziaei, Mohammed; Barsam, Allon; Shamie, Neda; Vroman, David; Kim, Terry; Donnenfeld, Eric D; Holland, Edward J; Kanellopoulos, John; Mah, Francis S; Randleman, J Bradley; Daya, Sheraz; Güell, Jose


    Corneal ectasia is a progressive, degenerative, and noninflammatory thinning disorder of the cornea. Recently developed corneal reshaping techniques have expanded the treatment armamentarium available to the corneal specialist by offering effective nontransplant options. This review summarizes the current evidence base for corneal collagen crosslinking, topography-guided photorefractive keratectomy, and intrastromal corneal ring segment implantation for the treatment of corneal ectasia by analyzing the data published between the years 2000 and 2014. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Late extrusion of intrastromal corneal ring segments: A report of two cases

    Directory of Open Access Journals (Sweden)

    Julius T. Oatts


    Conclusions and importance: Late extrusion can occur many years following implantation of ICRS, even in eyes without pre-existing thinning or ectasia. The technique for explantation described herein can result in favorable clinical outcomes in such cases. These cases demonstrate the importance of long-term follow up of eyes that have undergone ICRS implantation.

  12. Corneal collagen cross-linking (CXL) combined with refractive procedures for the treatment of corneal ectatic disorders: CXL plus. (United States)

    Kymionis, George D; Grentzelos, Michael A; Portaliou, Dimitra M; Kankariya, Vardhaman P; Randleman, J Bradley


    To discuss current combined corneal collagen cross-linking (CXL) and refractive surgical techniques (herein termed "CXL plus") for the treatment of corneal ectatic disorders to improve functional visual acuity in addition to corneal stability from CXL alone. Literature review. Efficacious combined treatments with CXL include: photorefractive keratectomy, transepithelial phototherapeutic keratectomy, intrastromal corneal ring segments implantation, phakic intraocular lens implantation, and multiple combined procedures. Some uncertainty remains as to the optimal strategies for each patient. A decision tree is proposed to facilitate optimal patient management. With multiple adjuvant techniques, CXL plus is likely to benefit many patients with corneal ectatic disorders. The appropriate combined procedure will depend on multiple factors, such as refraction, corneal thickness, and degree of irregular astigmatism. Copyright 2014, SLACK Incorporated.

  13. Histology and ultrastructure of picosecond laser intrastromal photorefractive keratectomy (ISPRK) (United States)

    Krueger, Ronald R.; Quantock, Andrew J.; Ito, Mitsutoshi; Assil, Kerry K.; Schanzlin, David J.


    Picosecond intrastromal ablation is currently under investigation as a new minimally invasive way of correcting refractive error. When the laser pulses are placed in an expanding spiral pattern along a lamellar plane, the technique is called intrastromal photorefractive keratectomy (ISPRK). We performed ISPRK on six human eye bank eyes. Thirty picosecond pulses at 1000 Hz and 20 - 25 (mu) J per pulse were separated by 15 microns. A total of 3 layers were placed in the anterior stroma separated by 15 microns. The eyes were then preserved and sectioned for light, scanning and transmission electron microscopy. Light and scanning electron microscopy reveals that picosecond intrastromal ablation using an ISPRK pattern demonstrates multiple, coalescing intrastromal cavities oriented parallel to the corneal surface. These cavities possess a smooth appearing inner wall. Using transmission electron microscopy, we noticed tissue loss surrounding some cavities with collagen fibril termination and thinning of collagen lamella. Other cavities we formed by separation of lamella with little evidence of tissue loss. A pseudomembrane lines the edge of some cavities. Although underlying tissue disruption was occasionally seen along the border of a cavity in no case was there any evidence of thermal damage or tissue necrosis. Ablation and loss of tissue in ISPRK results in nonthermal microscopic corneal thinning around some cavities whereas others demonstrate only lamellar separation. Alternative patterns and energy parameters should be investigated to bring this technology to its full potential in refractive surgery.

  14. [Surgical intrastromal keratopigmentation using tattoo ink]. (United States)

    Garrido-Hermosilla, A M; Ángeles-Figueroa, R A; Gessa-Sorroche, M


    A 31-year-old woman who had undergone surgery for a congenital cataract as a newborn developed bilateral malignant glaucoma, which was refractory to medical-surgical treatment. The patient currently has terminal glaucoma and severe band keratopathy. For aesthetic purposes, we performed intrastromal keratopigmentation surgery using ink for skin tattoos supplied in sterile single-dose vessels. No secondary effects or complications were observed. Keratopigmentation or corneal tattooing can now be used as a last resort in patients who are unable to tolerate cosmetic contact or intraocular lenses, or in whom corneal transplant is contraindicated. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  15. Creation and validation of a simulator for corneal rust ring removal. (United States)

    Mednick, Zale; Tabanfar, Reza; Alexander, Ashley; Simpson, Sarah; Baxter, Stephanie


    To create and validate a simulation model for corneal rust ring removal. Rust rings were created on cadaveric eyes with the use of small particles of metal. The eyes were mounted on suction plates at slit lamps and the trainees practiced rust ring removal. An inexperienced cohort of medical students and first year ophthalmology residents (n=11), and an experienced cohort of senior residents and faculty (n=11) removed the rust rings from the eyes with the use of a burr. Rust ring removal was evaluated based on removal time, percentage of rust removed and incidence of corneal perforation. A survey was administered to participants to determine face validity. Time for rust ring removal was longer in the inexperienced group at 187±93 seconds (range of 66-408 seconds), compared to the experienced group at 117±54 seconds (range of 55-240 seconds) (p=0.046). Removal speed was similar between groups, at 4847±4355 pixels/minute and 7206±5181 pixels/minute in the inexperienced and experienced groups, respectively (p=0.26). Removal percentage values were similar between groups, at 61±15% and 69±18% (p=0.38). There were no corneal perforations. 100% (22/22) of survey respondents believed the simulator would be a valuable practice tool, and 89% (17/19) felt the simulation was a valid representation of the clinical correlate. The corneal rust ring simulator presented here is a valid training tool that could be used by early trainees to gain greater comfort level before attempting rust ring removal on a live patient. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  16. Collagen cross-linking using riboflavin and ultraviolet-a for corneal thinning disorders: an evidence-based analysis. (United States)

    Pron, G; Ieraci, L; Kaulback, K


    The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B(2)) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions. SUBJECT OF THE EVIDENCE-BASED ANALYSIS: The primary treatment objective for corneal cross-linking is to increase the strength of the corneal stroma, thereby stabilizing the underlying disease process. At the present time, it is the only procedure that treats the underlying disease condition. The proposed advantages for corneal cross-linking are that the procedure is minimally invasive, safe and effective, and it can potentially delay or defer the need for a corneal transplant. In addition, corneal cross-linking does not adversely affect subsequent surgical approaches, if they are necessary, or interfere with corneal transplants. The evidence for these claims for corneal cross-linking in the management of corneal thinning disorders such as keratoconus will be the focus of this review. The specific research questions for the evidence review were as follows: TECHNICAL: How technically demanding is corneal cross-linking and what are the operative risks? What is known about the broader safety profile of corneal cross-linking?Effectiveness - Corneal Surface Topographic Affects:What are the corneal surface remodeling effects of corneal cross-linking?Do these changes interfere with subsequent interventions, particularly corneal transplant known as penetrating keratoplasty (PKP)?Effectiveness -Visual Acuity:What impacts does the remodeling have on visual acuity?Are these impacts predictable, stable, adjustable and

  17. Femtosecond infrared intrastromal ablation and backscattering-mode adaptive-optics multiphoton microscopy in chicken corneas. (United States)

    Gualda, Emilio J; Vázquez de Aldana, Javier R; Martínez-García, M Carmen; Moreno, Pablo; Hernández-Toro, Juan; Roso, Luis; Artal, Pablo; Bueno, Juan M


    The performance of femtosecond (fs) laser intrastromal ablation was evaluated with backscattering-mode adaptive-optics multiphoton microscopy in ex vivo chicken corneas. The pulse energy of the fs source used for ablation was set to generate two different ablation patterns within the corneal stroma at a certain depth. Intrastromal patterns were imaged with a custom adaptive-optics multiphoton microscope to determine the accuracy of the procedure and verify the outcomes. This study demonstrates the potential of using fs pulses as surgical and monitoring techniques to systematically investigate intratissue ablation. Further refinement of the experimental system by combining both functions into a single fs laser system would be the basis to establish new techniques capable of monitoring corneal surgery without labeling in real-time. Since the backscattering configuration has also been optimized, future in vivo implementations would also be of interest in clinical environments involving corneal ablation procedures.

  18. Inhibition of Corneal Neovascularization by Hydrazinocurcumin ...

    African Journals Online (AJOL)

    Purpose: To investigate the effect of hydrazinocurcumin on a human vascular endothelial growth factor (VEGF)-induced corneal neovascularization in rabbit model. Methods: Murine corneal neovascularization (CorNV) was induced via two intrastromal implantations of VEGF polymer 2 mm from the limbus.

  19. Unilateral corneal ectasia following small-incision lenticule extraction. (United States)

    Sachdev, Gitansha; Sachdev, Mahipal S; Sachdev, Ritika; Gupta, Hemlata


    We describe a case of unilateral corneal ectasia in a 26-year-old man following small-incision lenticule extraction. The preoperative corneal topography was normal, with a minimum corneal thickness of 511 μm and 513 μm in the right eye and left eye, respectively. Lenticules of 85 μm and 82 μm were fashioned to offer a refractive correction of -3.75 -1.50 × 180 and -3.50 -1.50 × 165 in the right eye and left eye, respectively. Twelve months after small-incision lenticule extraction, the patient presented with early signs of ectasia in the left eye on corneal topography, which had worsened at the 18-month examination. Intrastromal corneal ring segment implantation with corneal collagen crosslinking was performed to arrest further progression and to improve uncorrected distance visual acuity. On the last examination, the corrected distance visual acuity was 20/20(-2). Dr. Mahipal S. Sachdev receives travel grants from Carl Zeiss Meditec AG. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  20. [Management of corneal hydrops using air and micro-punctures]. (United States)

    Campos Polo, R; Chacón Iglesias, J; Gamazo Carrasco, M; Mencía Bartolomé, J M; Solana Fajardo, J; García Guisado, D; Fernández Miranda, C; Bueno Álvarez-Arenas, J; Sánchez Trancón, Á; García Ardoy, E


    A 22-year- old woman with an acute hydrops and Descemet membrane detachment was managed by intracameral air injection combined with multiple corneal stromal venting incisions for the drainage of intrastromal fluid. No intraoperative complications were encountered, and the intrastromal fluid was resolved over 2 weeks. Acute corneal hydrops is a significant complication of keratoconus. If not treated, resolution usually occurs over a period of 2-4 months. The persistent oedema can cause complications, such as corneal neovascularisation, infection and corneal perforation. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  1. Biomechanics of corneal ectasia and biomechanical treatments. (United States)

    Roberts, Cynthia J; Dupps, William J


    Many algorithms exist for the topographic/tomographic detection of corneas at risk for post-refractive surgery ectasia. It is proposed that the reason for the difficulty in finding a universal screening tool based on corneal morphologic features is that curvature, elevation, and pachymetric changes are all secondary signs of keratoconus and post-refractive surgery ectasia and that the primary abnormality is in the biomechanical properties. It is further proposed that the biomechanical modification is focal in nature, rather than a uniform generalized weakening, and that the focal reduction in elastic modulus precipitates a cycle of biomechanical decompensation that is driven by asymmetry in the biomechanical properties. This initiates a repeating cycle of increased strain, stress redistribution, and subsequent focal steepening and thinning. Various interventions are described in terms of how this cycle of biomechanical decompensation is interrupted, such as intrastromal corneal ring segments, which redistribute the corneal stress, and collagen crosslinking, which modifies the basic structural properties. Proprietary or commercial disclosures are listed after the references. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Removal and Repositioning of Intracorneal Ring Segments: Improving Corneal Topography and Clinical Outcomes in Keratoconus and Ectasia. (United States)

    Chan, Kahei; Hersh, Peter S


    To evaluate the efficacy of removal and relocation of intracorneal ring segments for improving outcomes in treatment of keratoconus and corneal ectasia. This is a retrospective case series conducted at a cornea and refractive surgery subspecialty practice setting. Patients with previous insertion of 2 intracorneal ring segments underwent surgical removal and repositioning of segments because of unsatisfactory visual and topographic outcomes. The principal outcomes included uncorrected and corrected visual acuities, manifest refraction, topography-derived maximum keratometry (Kmax), inferior-superior topography power difference (I - S), and higher-order aberration profile derived from wavefront analysis. Three patients are presented in this case series. Uncorrected visual acuity improved in all eyes by an average of 2.75 lines. Corrected visual acuity improved in 2 eyes and remained unchanged in 1 eye. Refractive astigmatism decreased in all patients by an average of 2.50 D. Kmax decreased by an average of 1.43 D. All patients had improvement in the I - S value with a mean decrease of 5.13 D. Topography-guided repositioning and/or replacement of corneal ring segments can result in improved topographic, optical, and visual outcomes in patients in whom the initial result is suboptimal. In these cases, a single segment repositioned beneath the cone resulted in an improved outcome. Analysis of corneal topography can guide the surgeon in treatment planning and can suggest patients in whom such an effort will be rewarded with better results.

  3. Intacs with or without same-day corneal collagen cross-linking to treat corneal ectasia. (United States)

    Legare, Marie Eve; Iovieno, Alfonso; Yeung, Sonia N; Lichtinger, Alejandro; Kim, Peter; Hollands, Simon; Slomovic, Allan R; Rootman, David S


    To compare combined intrastromal corneal ring segment implantation with same-day ultraviolet-A/riboflavin corneal collagen cross-linking (ICRS-CXL) versus ICRS implantation alone in patients with corneal ectasia. Retrospective comparative study. Sixty-six eyes from 54 patients with corneal ectasia were included in the study. The groups were composed of 32 eyes from 27 patients and 34 eyes from 27 patients for the ICRS-CXL and ICRS groups, respectively. We reviewed the charts of all patients who underwent these procedures from November 2008 to February 2011 for preoperative and for up to 1 year postoperative uncorrected (UDVA) and best corrected distance visual acuity (BDVA), refraction, topographical analysis (mean and steepest keratometry [K]), as well as root mean-square (RMS) of higher-order aberrations (HOAs). Overall, a significant improvement was seen in both groups for UDVA, BDVA, sphere, cylinder, mean refractive spherical equivalent (MRSE), mean and steepest K, coma, spherical and total HOA at 12 months. Trefoil did not improve, and higher-order astigmatism worsened in the ICRS group (p = 0.0466). There was no statistically significant difference between the 2 groups for visual acuity, sphere, cylinder, coma, trefoil, and spherical HOA. Outcomes were significantly more improved in the ICRS group for MRSE (p = 0.0082), mean K (p = 0.0021), steepest K (p = 0.0152), and total HOAs (p = 0.0208). No complications were observed. ICRS-CXL and ICRS alone were both safe and effective in treating corneal ectasia. The ICRS alone group demonstrated better outcomes of MRSE, mean and steepest K, as well as total HOA. Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  4. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov


    C, and collagen fiber diameter increase by 12.2 % (anterior stroma and 4.6 % (posterior stroma. In mild bullous keratopathy, corneal crosslinking provides antimicrobial effect. In moderate and severe keratopathy, crosslinking reduces pain and corneal edema and improves visual acuity immediately after the procedure. A case of HSV keratitis exacerbation was described. Amongst the complications, infection, halos, and posterior segment damage should be mentioned. Poor refractive results can be improved by the implantation of intrastromal corneal ring segments.

  5. Treatment With Intrastromal and Intracameral Voriconazole in 2 Eyes With Lasiodiplodia theobromae Keratitis (United States)

    Lekhanont, Kaevalin; Nonpassopon, Manachai; Nimvorapun, Nutthida; Santanirand, Pitak


    Abstract To report the clinical presentation and the role of intrastromal and intracameral voriconazole injection in the management of rare cases of fungal keratitis caused by Lasiodiplodia theobromae. Two eyes of 2 patients with Lasiodiplodia keratitis unresponsive to topical and oral antifungal medications were included in this study. Diagnosis of Lasiodiplodia keratitis was confirmed by microbiological analysis, including culture-based (case 1 and 2) and DNA sequencing techniques (case 2 only). The first patient presented with multiple satellite lesions and one of these infiltrates spread deeply into the cornea, forming a stromal abscess. Another patient had a large full-thickness corneal infiltrates with several fungal balls in the anterior chamber, requiring a limbus-to-limbus therapeutic penetrating keratoplasty. Despite aggressive topical therapy, the stromal abscess continued to worsen in the first case and recurrent keratitis was observed postoperatively in the second case. Voriconazole 50 μg/0.1 mL was administered intracamerally and intrastromally around the fungal abscess as adjuncts to topical antimycotics in the first case. The second patient who needed therapeutic keratoplasty was treated with an intracameral injection of 50 μg/0.1 mL voriconazole at the end of surgery. Postoperatively, 100 μg/0.1 mL voriconazole was also injected intracamerally after the recurrence of infection was noted in the graft. Reinjections were given 48 hours apart in both cases. After the injections, all corneal and anterior chamber lesions were reduced in size and density and completely resolved within 4 weeks. Intrastromal and intracameral voriconazole injections may offer safe and effective treatment options for L theobromae keratitis. PMID:25674759

  6. Corneal Laceration

    Medline Plus

    Full Text Available ... What Is Corneal Laceration? Corneal Laceration Symptoms What Causes Corneal Laceration? Corneal Laceration Diagnosis Corneal Laceration Treatment ... the corneal laceration is deep enough it can cause a full thickness laceration. This is when the ...

  7. New INTACS SK implantation in patients with post-laser in situ keratomileusis corneal ectasia. (United States)

    Kymionis, George D; Bouzoukis, Dimitrios I; Portaliou, Dimitra M; Pallikaris, Ioannis G


    In this case series, 2 patients with post-laser in situ keratomileusis corneal ectasia were included. Patients were treated with new intrastromal corneal ring segments, INTACS SK (severe keratoconus or steep "K") (Addition Technology, Inc, Des Plaines, IL) implantation. Two segments were inserted without any intraoperative or postoperative complications. Three months after the procedure, uncorrected visual acuity was improved in both patients from counting fingers preoperatively to 20/40 and 20/50, respectively. Best spectacle-corrected visual acuity improved from 20/40 to 20/32 and from 20/50 to 20/40. Manifest refraction improved from -8.75/-5.00 x 125 and -14.25/-6.50 x 33 preoperatively to -5.50/-2.25 x 125 and -8.25/-1.50 x 15 with an improvement in topographic findings. One year postoperatively, uncorrected visual acuity, best spectacle-corrected visual acuity, and topographic findings remained improved. In conclusion, new INTACS SK might be able to improve visual acuity in patients with post-laser in situ keratomileusis corneal ectasia.

  8. Continuous intracorneal ring implantation for keratoconus using a femtosecond laser. (United States)

    Jabbarvand, Mahmoud; Salamatrad, Ahmad; Hashemian, Hesam; Mazloumi, Mehdi; Khodaparast, Mehdi


    To assess the clinical outcomes after continuous intracorneal ring (ICR) implantation for the management of keratoconus using femtosecond laser technology. Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Prospective nonrandomized consecutive case series. All patients presented with reduced visual acuity, contact lens intolerance, and a central corneal thickness of more than 360 μm. A Myoring ICR was inserted in an intrastromal pocket created by a femtosecond laser. The visual, refractive, aberrometric, and corneal biomechanical outcomes were measured preoperatively as well as 1, 3, and 6 months and 1 year postoperatively. The study comprised 98 keratoconic eyes of 98 patients with a mean age of 30.7 years ± 9.01 (SD). Fifteen eyes (15.3%) had grade I keratoconus, 37 eyes (37.7%) had grade II keratoconus, 24 eyes (24.5%) had grade III keratoconus, and 22 eyes (22.4%) had grade IV keratoconus. The uncorrected and corrected distance visual acuities and spherical and cylindrical errors improved 1 month after surgery (P.05). The mean keratometry and corneal astigmatism decreased 1 month after surgery (P.05). Primary coma decreased significantly (P=.03), and spherical aberrations increased significantly (P<.001) postoperatively. Continuous ICR implantation in keratoconus appears to be an acceptable substitute for keratoplasty in advanced keratoconus. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Intrastromal Injection of China Painting Ink in Corneas of Male Rabbits: Clinical and Histological Study

    Directory of Open Access Journals (Sweden)

    Alahmady Hamad Alsmman Hassan


    Full Text Available Background. Many patients with corneal opacity or complicated cataract in blind eye ask for cosmoses. In this study we tried to investigate the staining of corneas of male rabbits by Rotring China painting ink and to study the histological changes. Method. 10 eyes of 10 male Baladi Egyptian rabbits were injected (0.1 mL intrastromally in the cornea by the use of China painting ink (Rotring Tinta China through insulin syringe (27-gauge needle by single injection; clinical follow-up is for 6 months and lastly the rabbits were scarified and the stained eyes were enucleated for histological analysis. Results. Clinically the stain was stable in color and distribution in corneas with no major complications. Histological results of the stained rabbit corneas showed blackish pigmentation in the corneal stroma without any inflammatory cellular infiltration. Some fibroblast cells had pigment granules in their cytoplasm in the adjacent layers. Conclusion. Corneal staining by China painting ink is effective and safe in staining of male rabbits cornea; however further study in human corneas with longer follow-up period is advisable.

  10. Design of computer-generated hologram with ring focus for nonmechanical corneal trephination with Er:YAG laser in penetrating keratoplasty. (United States)

    Langenbucher, A; Seitz, B; Kus, M M; van der Heyd, G; Köchle, M; Naumann, G O


    To calculate a beam-shaping optical element for homogeneous intensity distribution within a focal ring to be used in nonmechanical trephination with the Er:YAG laser in penetrating keratoplasty instead of a spot guiding device. The phase distribution behind a holographic optical element (HOE) k psi(u) can be described by the addition of the hologram phase phiH(u) to the beam phase phiE(u): k psi(u) = phiH(u) + phiE(u), k = 2pi/lambda, where u denotes the coordinates inside the hologram aperture, k an integer, and lambda the laser wavelength. To avoid discontinuous wavefronts leading to speckle noise, a smooth phase function is necessary. After transforming the hologram aperture coordinates into the focal plane x in a focal distance f, psi can be retrieved from the slope equation: inverted delta psi(u) = x(u) - u/f. Creating a ring focus can be reduced to an essentially one-dimensional problem by separation of variables due to the symmetry condition. We calculated a computer-generated eight-level phase-only HOE with 4096 x 4096 pixels from a Gaussian-distributed 2.94 Er:YAG laser spot with a beam diameter of 10 mm and a focal distance of 100 mm. Thereby, a ring focus with an inner/outer radius of 7/8 mm can be created. To avoid Poisson's spo, the symmetry of the problem was broken by circular modulation of the phase leading to a spiral-like structure. The calculated efficiency of the HOE relating the energy within the ring to the total energy was 91%. With an HOE it is possible to redistribute the energy along the desired focal ring. The HOE design can be adapted to the intensity distribution of the impinging laser beam with its characteristic aperture shape. A circular homogeneous corneal trephination depth is possible, because the energy fluctuation from pulse to pulse does not locally affect the ablation process. A ring focus for the Er:YAG laser has the potential to render superfluous a manual beam control via micromanipulator and to allow a more rapid and more

  11. Collagen Cross-Linking Using Riboflavin and Ultraviolet-A for Corneal Thinning Disorders (United States)

    Pron, G; Ieraci, L; Kaulback, K


    Executive Summary Objective The main objectives for this evidence-based analysis were to determine the safety and effectiveness of photochemical corneal collagen cross-linking with riboflavin (vitamin B2) and ultraviolet-A radiation, referred to as CXL, for the management of corneal thinning disease conditions. The comparative safety and effectiveness of corneal cross-linking with other minimally invasive treatments such as intrastromal corneal rings was also reviewed. The Medical Advisory Secretariat (MAS) evidence-based analysis was performed to support public financing decisions. Subject of the Evidence-Based Analysis The primary treatment objective for corneal cross-linking is to increase the strength of the corneal stroma, thereby stabilizing the underlying disease process. At the present time, it is the only procedure that treats the underlying disease condition. The proposed advantages for corneal cross-linking are that the procedure is minimally invasive, safe and effective, and it can potentially delay or defer the need for a corneal transplant. In addition, corneal cross-linking does not adversely affect subsequent surgical approaches, if they are necessary, or interfere with corneal transplants. The evidence for these claims for corneal cross-linking in the management of corneal thinning disorders such as keratoconus will be the focus of this review. The specific research questions for the evidence review were as follows: Technical: How technically demanding is corneal cross-linking and what are the operative risks? Safety: What is known about the broader safety profile of corneal cross-linking? Effectiveness - Corneal Surface Topographic Affects: What are the corneal surface remodeling effects of corneal cross-linking? Do these changes interfere with subsequent interventions, particularly corneal transplant known as penetrating keratoplasty (PKP)? Effectiveness -Visual Acuity: What impacts does the remodeling have on visual acuity? Are these impacts

  12. Corneal Ulcer (United States)

    ... Stories Español Eye Health / Eye Health A-Z Corneal Ulcer Sections What Is a Corneal Ulcer? Corneal Ulcer ... Ulcer Diagnosis Corneal Ulcer Treatment What Is a Corneal Ulcer? Leer en Español: ¿Qué es una úlcera de ...

  13. Histopathological features of equine superficial, nonhealing, corneal ulcers. (United States)

    Hempstead, Julie E; Clode, Alison B; Borst, Luke B; Gilger, Brian C


    To evaluate corneal changes associated with chronic, nonhealing, superficial, corneal ulcers in horses via common histopathological stains. Retrospective study. Twenty-four horses diagnosed with chronic, nonhealing, superficial, corneal ulceration. The medical records of horses evaluated at North Carolina State University's Veterinary Teaching Hospital (NCSU-VTH) from 2005 to 2011, diagnosed with a chronic, nonhealing, superficial, corneal ulcer and treated with superficial keratectomy (SK) were reviewed. Inclusion criteria were superficial corneal ulceration, no cellular infiltration via slit-lamp biomicroscopy, no microorganisms evident on corneal cytology, and acquisition of samples for aerobic bacterial and common fungal cultures. Corneal tissue samples were evaluated histopathologically for the presence or absence of a nonadherent epithelial 'lip', epithelial dysmaturity, intraepithelial inflammatory cells, an acellular hyaline zone in the anterior stroma, and stromal inflammatory cells, fibrosis and vascularization. In the majority of analyzed samples, epithelial cells adjacent to the ulcerated site showed nonadherence to the basement membrane and dysmaturity. Intraepithelial inflammatory cell infiltration was uncommon. Histopathological features of an anterior stromal hyaline zone, intrastromal inflammation, fibrosis and vascularization were variably present. The most consistent histopathological characteristics of equine chronic, nonhealing, superficial, corneal ulcers include epithelial nonadherence, epithelial dysmaturity and mild to moderate stromal inflammation; however, one set of histopathological characteristics does not definitively define this syndrome in horses. Additionally, the anterior stromal acellular hyaline zone commonly cited in canine spontaneous chronic corneal epithelial defects (SCCED) is not a consistent finding in equine corneas. © 2013 American College of Veterinary Ophthalmologists.

  14. Intrastromal voriconazole for deep recalcitrant fungal keratitis: a case series. (United States)

    Kalaiselvi, Ganapathy; Narayana, Sivananda; Krishnan, Tiruvengada; Sengupta, Sabyasachi


    To evaluate the outcomes of treating deep recalcitrant fungal keratitis with intrastromal voriconazole injection. Twenty-five patients with culture proven fungal keratitis, not responding to a combination of topical 5% natamycin and 1% voriconazole were treated with intrastromal voriconazole (50 µg/0.1 mL) injected in five divided doses around the infiltrate to form a depot of the drug around the circumference of the lesion. The mean age of the patients was 52.52±12.21 years and mean time to presentation was 17.12±13.75 days from the onset of symptoms. The mean area of the infiltrate was 30.41±17.2 mm(2), hypopyon was present in 88% and all cases had infiltrates that extended beyond the mid-stromal level. Intrastromal voriconazole helped to resolve the infection in 18 (72%) patients and about 15% of these needed more than one injection. Smaller ulcers responded better to treatment. Fusarium spp were responsible for six of the seven cases that failed treatment. Targeted delivery of voriconazole by intrastromal injection (50 µg/0.1 mL) is a safe and effective way to treat deep recalcitrant fungal keratitis, though some may need repeated injections. Fusarium keratitis may show suboptimal response but this needs further study. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  15. Corneal refractive surgery: Is intracorneal the way to go and what are the needs for technology? (United States)

    Hjortdal, Jesper; Ivarsen, Anders


    Corneal refractive surgery aims to reduce or eliminate refractive errors of the eye by changing the refractive power of the cornea. For the last 20 years controlled excimer laser ablation of corneal tissue, either directly from the corneal stromal surface or from the corneal interior after creation of a superficial corneal flap has become widely used to correct myopia, hyperopia, and astigmatism. Recently, an intrastromal refractive procedure whereby a tissue lenticule is cut free in the corneal stroma by a femtosecond laser and removed through a small peripheral incision has been introduced. This procedure avoids creation of a corneal flap and the potential associated risks while avoiding the slow visual recovery of surface ablation procedures. Precise intrastromal femtosecond laser cutting of the fine lenticule requires very controlled laser energy delivery in order to avoid lenticule irregularities, which would compromise the refractive result and visual acuity. This newly introduced all-femtosecond based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient, and safe procedure for correction of myopia and astigmatism. Technological developments related to further improved cutting quality, hyperopic and individualized treatments are desirable.

  16. Corneal dystrophies

    Directory of Open Access Journals (Sweden)

    Klintworth Gordon K


    Full Text Available Abstract The term corneal dystrophy embraces a heterogenous group of bilateral genetically determined non-inflammatory corneal diseases that are restricted to the cornea. The designation is imprecise but remains in vogue because of its clinical value. Clinically, the corneal dystrophies can be divided into three groups based on the sole or predominant anatomical location of the abnormalities. Some affect primarily the corneal epithelium and its basement membrane or Bowman layer and the superficial corneal stroma (anterior corneal dystrophies, the corneal stroma (stromal corneal dystrophies, or Descemet membrane and the corneal endothelium (posterior corneal dystrophies. Most corneal dystrophies have no systemic manifestations and present with variable shaped corneal opacities in a clear or cloudy cornea and they affect visual acuity to different degrees. Corneal dystrophies may have a simple autosomal dominant, autosomal recessive or X-linked recessive Mendelian mode of inheritance. Different corneal dystrophies are caused by mutations in the CHST6, KRT3, KRT12, PIP5K3, SLC4A11, TACSTD2, TGFBI, and UBIAD1 genes. Knowledge about the responsible genetic mutations responsible for these disorders has led to a better understanding of their basic defect and to molecular tests for their precise diagnosis. Genes for other corneal dystrophies have been mapped to specific chromosomal loci, but have not yet been identified. As clinical manifestations widely vary with the different entities, corneal dystrophies should be suspected when corneal transparency is lost or corneal opacities occur spontaneously, particularly in both corneas, and especially in the presence of a positive family history or in the offspring of consanguineous parents. Main differential diagnoses include various causes of monoclonal gammopathy, lecithin-cholesterol-acyltransferase deficiency, Fabry disease, cystinosis, tyrosine transaminase deficiency, systemic lysosomal storage

  17. Pachymetry-guided intrastromal air injection ("pachy-bubble") for deep anterior lamellar keratoplasty. (United States)

    Ghanem, Ramon C; Ghanem, Marcielle A


    To evaluate an innovative technique for intrastromal air injection to achieve deep anterior lamellar keratoplasty (DALK) with bare Descemet membrane (DM). Thirty-four eyes with anterior corneal pathology, including 27 with keratoconus, underwent DALK. After 400 μm trephination with a suction trephine, ultrasound pachymetry was performed 0.8 mm internally from the trephination groove in the 11 to 1 o'clock position. In this area, a 2-mm incision was created, parallel to the groove, with a micrometer diamond knife calibrated to 90% depth of the thinnest measurement. A cannula was inserted through the incision and 0.5 mL of air was injected to dissect the DM from the stroma. After peripheral paracentesis, anterior keratectomy was carried out to bare the DM. A 0.25-mm oversized graft was sutured in place. Overall, 94.1% of eyes achieved DALK. Bare DM was achieved in 30 eyes, and a pre-DM dissection was performed in 2 eyes. Air injection was successful in detaching the DM (achieving the big bubble) in 88.2% of the eyes. In keratoconus eyes, the rate was 88.9%. All cases but one required a single air injection to achieve DM detachment. Microperforations occurred in 5 cases: 3 during manual layer-by-layer dissection after air injection failed to detach the DM, 1 during removal of the residual stroma after big-bubble formation, and 1 during the diamond knife incision. Two cases (5.9%) were converted to penetrating keratoplasty because of macroperforations. The technique was reproducible, safe, and highly effective in promoting DALK with bare DM.

  18. Three-dimensional modeling of metabolic species transport in the cornea with a hydrogel intrastromal inlay. (United States)

    Pinsky, Peter M


    Intrastromal inlays for refractive correction of presbyopia are being adopted into clinical practice. An important concern is the effect of the inlay on the long-term health of the cornea due to disturbances in the concentration profiles of metabolic species. A three-dimensional metabolic model for the cornea is employed to investigate oxygen, glucose, and lactate ion transport in the cornea and to estimate changes in species concentrations induced by the introduction of a hydrogel inlay. A reaction-diffusion metabolic model, appropriate for highly oxygen-permeable hydrogel inlays, is used to describe cellular consumption of oxygen and glucose and production of lactic acid. A three-layer corneal geometry (epithelium, stroma, endothelium) is employed with a hydrogel inlay placed under a lamellar flap. The model is solved numerically by the finite element method. For a commercially available hydrogel material with a relative inlay diffusivity of 43.5%, maximum glucose depletion and lactate ion accumulation occur anterior to the inlay and both are less than 3%. Below 20% relative diffusivity, glucose depletion and lactate ion accumulation increase exponentially. Glucose depletion increases slightly with increasing depth of inlay placement. The flux of metabolic species is modified by an inlay, depending on the inlay relative diffusivity. For commercially available hydrogel materials and a typical inlay design, predicted changes in species concentrations are small when compared to the variation of concentrations across the normal cornea. In general, glucose depletion and lactate ion accumulation are highly sensitive to inlay diffusivity and somewhat insensitive to inlay depth. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  19. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué Es una Laceración de la Córnea? Written ...

  20. Corneal Laceration

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    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration ... Laceration Treatment What Is Corneal Laceration? Leer en Español: ¿Qué es una laceración de la córnea? Written ...

  1. Corneal Laceration

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    Full Text Available ... Health Find an Ophthalmologist Academy Store Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask ... Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal Laceration Sections What Is Corneal Laceration? ...

  2. Cross-Linking Treatment and Corneal Transplant in Refractory Acremonium Keratitis: Case Report. (United States)

    Yagci, Ayse; Palamar, Melis; Polat Hilmioglu, Suleyha; Irkec, Murat


    To report a case of Acremonium keratitis treated with voriconazole, corneal collagen cross-linking, and corneal transplant. Case report. A 42-year-old woman who wore contact lenses daily was referred for refractory keratitis. Her main complaints were gritty sensation and pain. At slit lamp biomicroscopy, an infiltrate on the inferior paracentral cornea and an arcuate conjunctival ulceration were evident. The rest of the cornea was clear with no anterior chamber reaction. Scrapings from the corneal ulcer showed Candida parapsilosis and Acremonium species, which were sensitive to voriconazole. Despite the administration of topical, systemic, and intrastromal voriconazole for 1 month, repeat corneal scraping was positive for Acremonium, and clinical appearance and pain did not resolve. Therefore, corneal collagen cross-linking was applied. Although the pain resolved immediately after the procedure, the lesion showed no improvement. After a month of cross-linking, corneal transplant was performed for visual rehabilitation and treatment of the refractory lesion. The excised corneal button was negative for any microorganisms. Although corneal collagen cross-linking may be an effective treatment for Acremonium keratitis refractory to medical therapy, corneal transplant was required for visual gain and recovery.

  3. Applications of corneal topography and tomography: a review. (United States)

    Fan, Rachel; Chan, Tommy Cy; Prakash, Gaurav; Jhanji, Vishal


    Corneal imaging is essential for diagnosing and management of a wide variety of ocular diseases. Corneal topography is used to characterize the shape of the cornea, specifically, the anterior surface of the cornea. Most corneal topographical systems are based on Placido disc that analyse rings that are reflected off the corneal surface. The posterior corneal surface cannot be characterized using Placido disc technology. Imaging of the posterior corneal surface is useful for diagnosis of corneal ectasia. Unlike corneal topographers, tomographers generate a three-dimensional recreation of the anterior segment and provide information about the corneal thickness. Scheimpflug imaging is one of the most commonly used techniques for corneal tomography. The cross-sectional images generated by a rotating Scheimpflug camera are used to locate the anterior and posterior corneal surfaces. The clinical uses of corneal topography include, diagnosis of corneal ectasia, assessment of corneal astigmatism, and refractive surgery planning. This review will discuss the applications of corneal topography and tomography in clinical practice. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  4. Experimental study on cryotherapy for fungal corneal ulcer. (United States)

    Chen, Yingxin; Yang, Weijia; Gao, Minghong; Belin, Michael Wellington; Yu, Hai; Yu, Jing


    Fungal corneal ulcer is one of the major causes of visual impairment worldwide. Treatment of fungal corneal ulcer mainly depends on anti-fungal agents. In the current study, we developed an integrated combination therapy of cryotherapy and anti-fungal agents to facilitate effective treatment of fungal corneal ulcer. Rabbit models of cornea infection were established using a combined method of intrastromal injection and keratoplasty. After treatment with cryotherapy and anti-fungal agents, scanning electron microscopy, transmission electron microscopy, and confocal microscopy were conducted to observe changes in microstructure in the rabbits. Periodic acid Schiff A and hematoxylin and eosin staining were used for detection of histological changes. Continuous scanning electron microscopy and transmission electron microscopy observations showed that cryothermal treatment inhibited growth of fungal mycelium by destroying fungal cellular structures. Typical cryotherapy was effective in curing fungal corneal ulcer. Different fungi showed different susceptibilities to treatment. The curative effect of Candida albicans was the best, while that of Aspergillus fumigates was the worst. Our study provides a novel method of a combination of cryotherapy and anti-fungal agents for treatment of fungal corneal ulcer. This treatment could help facilitate the practice of fungal keratitis treatment in the future.

  5. Corneal injury (United States)

    ... page: // Corneal injury To use the sharing features on this page, ... Hockberger RS, Walls RM, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  6. Corneal Laceration

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    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Eye ... What Is Corneal Laceration? Leer en Español: ¿Qué ...

  7. Corneal Laceration

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    Full Text Available ... itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe ... Ask an Ophthalmologist Answers Did my traumatic brain injury cause early cataracts? Jan 21, 2018 Did I ...

  8. Corneal Laceration

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    Full Text Available ... and causes a ruptured globe, a tear into the eyeball itself. A corneal laceration is a very serious injury and requires immediate medical attention to avoid severe vision loss. If your eye ...

  9. Corneal Laceration

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    Full Text Available ... may increase bleeding after you have finished protecting the eye, see a physician immediately Next Corneal Laceration Symptoms Related Ask an Ophthalmologist Answers Did my traumatic brain injury cause early cataracts? Jan 21, 2018 Did ...

  10. Corneal Laceration

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    Full Text Available ... inflammatory drugs. These drugs thin the blood and may increase bleeding after you have finished protecting the ... Rise Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation ...

  11. Corneal Laceration

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    Full Text Available ... part of a paper cup and tape this piece to the area around the eye. Wear this ... it possible that wearing two contact lenses in one eye could have caused a corneal ulcer? Jun ...

  12. Corneal Laceration

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    Full Text Available ... increase bleeding after you have finished protecting the eye, see a physician immediately Next Corneal Laceration Symptoms Related Ask an Ophthalmologist Answers Did my traumatic brain injury cause early cataracts? Jan 21, 2018 Did ...

  13. Corneal Laceration

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    Full Text Available ... the blood and may increase bleeding after you have finished protecting the eye, see a physician immediately ... Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov ...

  14. Corneal-Based Surgical Presbyopic Therapies and Their Application in Pseudophakic Patients (United States)

    Paley, Grace L.; Chuck, Roy S.


    Purpose. The purpose of this review is to provide a summary of laser refractive surgery and corneal inlay approaches to treat presbyopia in patients after cataract surgery. Summary. The presbyopic population is growing rapidly along with increasing demands for spectacle independence. This review will focus on the corneal-based surgical options to address presbyopia including various types of corneal intrastromal inlays and laser ablation techniques to generate either a multifocal cornea (“PresbyLASIK”) or monovision. The natural history of presbyopia develops prior to cataracts, and these presbyopic surgeries have been largely studied in phakic patients. Nevertheless, pseudophakic patients may also undergo these presbyopia-compensating procedures for enhanced quality of life. This review examines the published reports that apply these technologies to patients after cataract surgery and discusses unique considerations for this population. PMID:27051527

  15. Corneal-Based Surgical Presbyopic Therapies and Their Application in Pseudophakic Patients

    Directory of Open Access Journals (Sweden)

    Grace L. Paley


    Full Text Available Purpose. The purpose of this review is to provide a summary of laser refractive surgery and corneal inlay approaches to treat presbyopia in patients after cataract surgery. Summary. The presbyopic population is growing rapidly along with increasing demands for spectacle independence. This review will focus on the corneal-based surgical options to address presbyopia including various types of corneal intrastromal inlays and laser ablation techniques to generate either a multifocal cornea (“PresbyLASIK” or monovision. The natural history of presbyopia develops prior to cataracts, and these presbyopic surgeries have been largely studied in phakic patients. Nevertheless, pseudophakic patients may also undergo these presbyopia-compensating procedures for enhanced quality of life. This review examines the published reports that apply these technologies to patients after cataract surgery and discusses unique considerations for this population.

  16. Corneal Transplantation

    DEFF Research Database (Denmark)

    Hjortdal, Jesper Østergaard

    Corneal transplantation has been performed for more than 100 years. Until 15 years ago the state-of-the art type of transplantation was penetrating keratoplasty, but since the start of this millennium, newly designed surgical techniques have developed considerably. Today, the vast majority of ker...

  17. Corneal Laceration

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    Full Text Available ... Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Corneal ... vision. Privacy Policy Related Top 5 Eye Health Stories of 2017 Dec 21, 2017 Solar Eclipse Inflicts ...

  18. Corneal topography

    DEFF Research Database (Denmark)

    Andersen, J.; Koch-Jensen, P.; Østerby, Ole


    The central corneal zone is depicted on keratoscope photographs using a small target aperture and a large object distance. Information on the peripheral area is included by employing a hemispherical target with a dense circular and radial pattern. On a 16 mm (R = 8 mm) reference steel sphere the ...

  19. Corneal Laceration

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    Full Text Available ... Laundry Packets On the Rise Jun 30, 2017 People with Advanced Keratoconus May Have A Future Alternative to Full Corneal Transplantation Nov 29, ... Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of ...

  20. Corneal Intelligence

    African Journals Online (AJOL)


    Corneal Intelligence. Ian Murdoch. Institute of Ophthalmology, Bath Street, London. In 2002, the ocular hypertension treatment study (OHTS) published their results. This study had taken 1636 ocular hypertensives. 1, 2. (IOP 24-32mmHg) and randomized them to receive therapy or no therapy. The primary outcome of the ...

  1. Corneal Laceration

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    Full Text Available ... lenses in one eye could have caused a corneal ulcer? Jun 05, 2015 Find an Ophthalmologist Advanced Search Ask an Ophthalmologist Browse Answers Free Newsletter Get ophthalmologist-reviewed tips and information about eye health and ... The Academy Professionals: ...

  2. Corneal perforation by an astigmatic keratotomy performed with an optical coherence tomography-guided femtosecond laser. (United States)

    Cherfan, Daniel G; Melki, Samir A


    We present a case of corneal perforation secondary to an intrastromal astigmatic keratotomy performed with an optical coherence tomography-guided femtosecond laser. The keratotomy was concomitant with cataract surgery and resulted in a flat anterior chamber prior to the start of lens extraction. Interrupted nylon sutures were placed to seal the keratotomy prior to phacoemulsification. Escape of cavitation bubbles into the anterior chamber or the liquid interface can alert the surgeon to the possibility of unintended perforation of the endothelium or the epithelium, respectively. Neither author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Experimental results of preparing laser-shaped stromal implants for laser-assisted intrastromal keratophakia in extremely complicated laser in situ keratomileusis cases. (United States)

    Jankov, Mirko; Mrochen, Michael C; Bueeler, Michael; Seiler, Theo


    To evaluate the feasibility of laser-shaped stromal implants from a donor eye for correcting extreme high hyperopia with irregular astigmatism and an exceptionally thin corneal bed. Thirty-one fresh enucleated porcine eyes were used. The procedure was initiated with mechanical de-epithelialization followed by a lamellar cut with a microkeratome, resulting in a hinged flap (thickness 150 microm, diameter 9.5 mm). The cornea was photoablated with PRK treatment for +8.00 D sphere (hyperopic lenticule group) and -5.00 D sphere (myopic group) by a scanning spot excimer laser. A customized scanning software algorithm was used to create a circumferential cut with a 6.5-mm internal diameter. The lenticule was removed from the stromal bed and measured by a surface profiling system. A clinical case was performed on a patient with previous LASIK and highly irregular hyperopic astigmatism to verify the clinical utility of the experimental setup. Under the microscope, lenticules seemed round, regular, and transparent. The average surface profile of porcine corneas demonstrated good parabolic shape with individual variations as large as 30 microm, probably due to the corneal size and curvature differences between the porcine eye and the human eye--for which the microkeratome is designed. The patient underwent a topography-guided treatment after laser-assisted intrastromal keratophakia (LAIK) and 1-month follow-up showed an increase of UCVA, BSCVA, and central corneal thickness. The use of modern scanning-spot excimer lasers and microkeratomes enabled us to produce stromal lenticules of good quality, which might be acceptable to implant into a human eye.

  4. Advantages of nerve-sparing intrastromal total abdominal hysterectomy

    Directory of Open Access Journals (Sweden)

    Samimi D


    Full Text Available Daryoosh Samimi,1 Afdal Allam,2 Robert Devereaux,2 William Han,2 Mark Monroe21Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 2Department of Obstetrics and Gynecology, Fountain Valley Regional Hospital, Fountain Valley, CA, USABackground: The purpose of the prospective study was to evaluate the effect of the nerve-sparing intrastromal abdominal hysterectomy bilateral salpingo-oophorectomy (ISTAH-BSO on intraoperative, and postoperative complications namely blood loss and length of hospital stay.Methods: Forty female patients were allocated by a block randomization method into a study group and a control group. The study group consisted of 20 patients who underwent ISTAH-BSO over a 2-year period. The control group included 20 patients who underwent conventional hysterectomy by the same surgeon during the same time frame. Both groups were followed for outcomes of interest, which included length of hospital stay, blood loss, and surgical complications. The participants in both groups were as similar as possible with respect to all known or unknown factors that might affect the study outcome.Results: Postoperative hemoglobin levels were higher in the study group (blood loss 1.0 g/dL versus 1.4 g/dL in control group. Average hospital stay was significantly shorter in the study group (2.7 days versus 3.15 days in the control group, P = 0.028. No significant complications such as urinary fistula, vaginal vault prolapse, blood transfusion, or postoperative infections were identified in the study group.Conclusion: The nerve-sparing ISTAH-BSO procedure described in this study has the potential to reduce length of hospital stay after abdominal hysterectomy by reducing blood loss and postoperative complications. Follow-up observations suggest that urinary function and sexual satisfaction are also preserved. Since this research, 175 cases have been performed, with an average of 5 years of

  5. Corneal Laceration

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    Full Text Available ... about eye health and preserving your vision. Privacy Policy Related The Mystery of the Ghostly White Ring ... Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  6. Corneal iron line associated with steep central islands after photorefractive keratectomy. (United States)

    Krueger, R R; Tersi, I; Seiler, T


    To report a new corneal iron deposit after excimer laser photorefractive keratectomy (PRK). Two patients with symptomatic persistent steep central islands were noted to have a corneal iron ring at 6 months to 1 year after surgery. This is different from the central iron spot noted in most patients at 1 year. One patient had repeated PRK with improvement of his symptoms and resolution of the iron ring. A corneal iron ring after excimer laser PRK suggests the presence of a persistent steep central island of stromal origin. Since corneal iron deposition signifies chronicity, symptomatic patients should be retreated as resolution of the steep central island is not likely to occur.

  7. 21 CFR 886.4070 - Powered corneal burr. (United States)


    ... to remove rust rings from the cornea of the eye. (b) Classification. Class I (general controls). When intended only for rust ring removal, the device is exempt from the premarket notification procedures in... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered corneal burr. 886.4070 Section 886.4070...

  8. Intravital two-photon microscopy of immune cell dynamics in corneal lymphatic vessels.

    Directory of Open Access Journals (Sweden)

    Philipp Steven

    Full Text Available BACKGROUND: The role of lymphatic vessels in tissue and organ transplantation as well as in tumor growth and metastasis has drawn great attention in recent years. METHODOLOGY/PRINCIPAL FINDINGS: We now developed a novel method using non-invasive two-photon microscopy to simultaneously visualize and track specifically stained lymphatic vessels and autofluorescent adjacent tissues such as collagen fibrils, blood vessels and immune cells in the mouse model of corneal neovascularization in vivo. The mouse cornea serves as an ideal tissue for this technique due to its easy accessibility and its inducible and modifiable state of pathological hem- and lymphvascularization. Neovascularization was induced by suture placement in corneas of Balb/C mice. Two weeks after treatment, lymphatic vessels were stained intravital by intrastromal injection of a fluorescently labeled LYVE-1 antibody and the corneas were evaluated in vivo by two-photon microscopy (TPM. Intravital TPM was performed at 710 nm and 826 nm excitation wavelengths to detect immunofluorescence and tissue autofluorescence using a custom made animal holder. Corneas were then harvested, fixed and analyzed by histology. Time lapse imaging demonstrated the first in vivo evidence of immune cell migration into lymphatic vessels and luminal transport of individual cells. Cells immigrated within 1-5.5 min into the vessel lumen. Mean velocities of intrastromal corneal immune cells were around 9 µm/min and therefore comparable to those of T-cells and macrophages in other mucosal surfaces. CONCLUSIONS: To our knowledge we here demonstrate for the first time the intravital real-time transmigration of immune cells into lymphatic vessels. Overall this study demonstrates the valuable use of intravital autofluorescence two-photon microscopy in the model of suture-induced corneal vascularizations to study interactions of immune and subsequently tumor cells with lymphatic vessels under close as possible

  9. Equine corneal stromal abscesses

    DEFF Research Database (Denmark)

    Henriksen, M. D. L.; Andersen, P. H.; Plummer, C. E.


    The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal...... foreign bodies in horses. They were more commonly diagnosed in horses living in subtropical climatic areas of the world. Therapeutic recommendations to treat equine SAs were historically nearly always a medical approach directed at bacteria and the often associated severe iridocyclitis. Today...... the pathogenesis of most equine SAs appears to be more often related to fungal inoculation of the anterior corneal stroma followed by posterior migration of the fungi deeper into the corneal stroma. There is also now an increased incidence of diagnosis of corneal SAs in horses living in more temperate climates...

  10. ["En face" anterior segment optical coherence tomography findings in acute corneal hydrops]. (United States)

    Kallel, S; Tahiri Joutei Hassani, R; Liang, H; Baudouin, C; Labbé, A


    To study the corneal morphological characteristics of acute hydrops by analyzing anterior segment optical coherence tomography (AS-OCT) "en face" images. Four patients presenting with acute hydrops were examined at different stages, respectively after 1 day, 1 week, 3 weeks and 6 months. All patients had a complete ophthalmic evaluation including "en face" AS-OCT examination. In vivo confocal microscopy (IVCM) and histological analysis of the cornea obtained after penetrating keratoplasty were also performed in one patient. The "en face" AS-OCT showed that the early edema in acute hydrops corresponded to multiple epithelial microcysts associated with large intra-stromal lacunae. We also observed that, in association with the disappearance of the microcysts and lacunae, "en face" OCT demonstrated subepithelial scars in the form of weakly reflective, fine, interlaced linear opacities. These opacities subsequently increased in thickness resulting in a dense subepithelial network. These findings were consistent with the results of histological and IVCM studies. "En face" AS-OCT allows for precise study of the tissue changes occurring in acute corneal hydrops. Besides a better understanding of this rare complication of keratoconus, this new imaging technique may help clinicians to identify the corneal structural changes, which place keratoconus patients at risk of corneal hydrops. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  11. Estudo das modificações oculares induzidas pelo implante estromal do anel de Ferrara em portadores de ceratocone Study of the ocular changes after stromal Ferrara ring implantation in patients with keratoconus

    Directory of Open Access Journals (Sweden)

    Paulo Ferrara de Almeida Cunha


    Full Text Available OBJETIVO: Comparar a acuidade visual com e sem correção, ceratometria média e equivalente esférico antes e após o implante do anel intraestromal de Ferrara em pacientes portadores de ceratocone intolerantes a lentes de contato. MÉTODOS: Foram analisados os primeiros 400 olhos com ceratocone tratados com o implante do anel de Ferrara, levando-se em consideração as alterações obtidas na curvatura corneana, acuidade visual e refração, bem como a estabilidade dos resultados no primeiro ano. RESULTADOS: Nos 400 olhos estudados, observamos redução média na curvatura corneana de 4,18 D, o equivalente esférico diminuiu 4,65 D quando comparamos os valores obtidos no pré-operatório e os do último exame realizado. A AV média não corrigida foi a que sofreu maior alteração, passando de PURPOSE: To compare the changes in corneal curvature, visual acuity and spherical equivalent before and after the implantation of the intrastromal corneal Ferrara ring in contact lens intolerant keratoconus patients. METHODS: The first 400 eyes treated with the Ferrara ring were evaluated according to the alterations obtained in the corneal curvature, visual acuity and refraction after surgery, as well as the stability of the results in the first year. RESULTS: In the 400-studied eyes, there was a mean reduction of 4.18 D in keratometry and 4.65 D in spherical equivalent. The mean uncorrected visual acuity showed the greatest improvement varying from less than 20/400 before to 20/100 after surgery. The mean BSCVA was 20/50 after the surgery. The more advanced keratoconus (III/IV groups showed the greatest reduction in keratometry. The correction remained stable along the period of the study in all groups. CONCLUSION: The Ferrara ring showed to produce reduction of myopia, regularization of the cornea and consequent corrections of the irregular astigmatism, disappearance of the keratoconic pattern and a significant improvement of the corrected and

  12. Random Implantation of Asymmetric Intracorneal Rings

    Directory of Open Access Journals (Sweden)

    Cristina Peris-Martínez


    Full Text Available Intracorneal ring employment for treating ectasia is widespread. Although the mechanism of action of intracorneal rings in the regularization of the corneal surface after its implantation is well known in most cases, there are still many doubts. We present a case of implanted intracorneal rings, where, despite the peculiar position of the rings, the patient gains lines of visual acuity and keratoconus remains stable.

  13. Development of a novel ex vivo equine corneal model. (United States)

    Marlo, Todd L; Giuliano, Elizabeth A; Sharma, Ajay; Mohan, Rajiv R


    To develop an ex vivo equine corneal organ culture model. Specifically, to assess the equine cornea's extracellular matrix and cellularity after 7 days using two different culture techniques: either (i) immersion system or (ii) air/liquid interface system, to determine the best ex vivo equine corneal model. Fourteen healthy equine corneas of various breeds. Equine corneas with 2 mm of perilimbal sclera were freshly harvested from 7 horses undergoing humane euthanasia. One corneal-scleral ring (CSR) from each horse was randomly placed in the (i) immersion condition organ culture system (IC), with the contralateral CSR being placed in the (ii) air/liquid interface organ culture system (ALC) for 7 days. All corneas were evaluated using serial daily gross photography, histology, qPCR, and TUNEL assay. corneal-scleral rings placed in the IC (i) had complete loss of corneal transparency on gross photography by 7 days, showed a significant level of corneal stromal disorganization, significantly increased α-SMA levels on qPCR, and apoptosis on TUNEL assay compared to controls. The ALC (ii) had weak stromal disorganization on histopathologic examination and was not significantly different from normal equine corneal controls on all other evaluated parameters. The air-liquid interface organ culture system maintains the equine cornea's extracellular matrix and preserves corneal transparency, while the immersion condition results in near complete degradation of normal equine corneal architecture after 7 days in culture. The air-liquid organ culture is a viable option to maintain a healthy equine cornea in an ex vivo setting for wound healing studies. © 2016 American College of Veterinary Ophthalmologists.

  14. Utilização do Anel de Ferrara na estabilização e correção da ectasia corneana pós PRK Use of Ferrara's ring in the stabilization and correction of corneal ectasia after PRK

    Directory of Open Access Journals (Sweden)

    Frederico Bicalho Dias da Silva


    Full Text Available Objetivo: Avaliar a ação do anel corneano intra-estromal de Ferrara no tratamento da ectasia corneana pós Excimer Laser. Métodos: O anel de Ferrara, que já vem sendo aplicado no tratamento do ceratocone, alta miopia e astigmatismo irregular, foi utilizado para estabilizar e corrigir a ectasia corneana de dois pacientes submetidos à PRK. Resultados: Após o procedimento cirúrgico, foi observado um aplainamento da córnea central de aproximadamente 6 dioptrias no 1º caso e de 10 dioptrias no 2º, com melhora na acuidade visual. Os resultados vêm se mantendo estáveis até o momento. O tempo de seguimento pós-operatório foi de 3 e 8 meses, respectivamente. Conclusões: Anel de Ferrara obteve sucesso no difícil tratamento desta complicação cirúrgica, permitindo que se retarde ou até mesmo se evite a evolução destes casos para um transplante de córnea com todos os seus riscos, lenta recuperação e dependência da agilidade das filas de doações.Purpose: To evaluate the action of Ferrara's Ring in the treatment of corneal ectasia after Excimer Laser. Methods: Ferrara's Ring, that is already being applied in the treatment of keratoconus, high myopia and irregular astigmatism, has been used to stabilize and to correct the corneal ectasia of 2 patients submitted to PRK. Results: After the surgical procedure, a flattening of the central cornea was observed, with approximately 6 D (first case and 10 D in the second, with visual acuity improvement. The results have remained stable until this moment. The postoperative follow-up was of 3 and 8 months, respectively. Conclusions: Ferrara's ring has obtained success in the difficult treatment of this surgical complication, allowing delay of or even avoiding the evolution of these cases to a corneal transplantation with all its risks, slow recovery and dependence on the agility of the donation lines.

  15. Corneal Protection for Burn Patients (United States)


    Create ectropion by blepharoplasty in New Zealand white rabbits. Assess epithelial defects and corneal ulcers . Measure inflammatory cytokines and...7, with corneal ulceration developing in the most severe cases by week 3. Histopathological results revealed epithelium infiltrated by heterophilic...excellent surgical model of evaporative dry eye. Damage to the cornea and conjunctiva manifesting as punctate epithelial erosions and corneal ulceration is

  16. Late Stage of Corneal Decompensation Caused by Progressive Keratoconus: Can We Treat It and Save the Cornea?

    Directory of Open Access Journals (Sweden)

    Igor Knezović


    Full Text Available Aim. To report a case of 40-year-old male with progressive bilateral keratoconus who had undergone transepithelial phototherapeutic keratectomy (TE-PTK and corneal collagen cross-linking (CXL using hypoosmolar riboflavin solution in a same day procedure. Methods. Eye examination showed that UCDVA on both eyes was 0,01 according to Snellen charts, and slit lamp biomicroscopy showed paracentral diffuse intrastromal corneal haze. Anterior OCT marked stromal hyperreflective zones and localized paracentral thinning of the cornea. Scheimpflug tomography noted keratoconus stages III-IV on both eyes. After 40/35 microns TE-PTK, a CXL was performed for 30 minutes using hypoosmolar riboflavin solution. The left eye was treated first and the right eye 1 month after. Follow-up period was 10 months. Results. One month after the treatment both eyes showed improvement in corneal topography and the UCDVA was better. Eight months after the treatment BSCVA improved to 0,6 in both eyes using Rose K2 contact lenses and remained stable. Conclusion. TE-PTK and CXL using hypotonic riboflavin solution as a same day procedure have been shown to be a safe and promising method in this case of progressive keratoconus. It was necessary to consider certain parameters that could influence the safety and the final outcome of this combined protocol.

  17. Corneal topographer based on the Hartmann test. (United States)

    Mejía, Yobani; Galeano, Janneth C


    The purpose of this article is to show the performance of a topographer based on the Hartmann test for convex surfaces of F/# approximately 1. This topographer, called "Hartmann Test topographer (HT topographer)," is a prototype developed in the Physics Department of the Universidad Nacional de Colombia. From the Hartmann pattern generated by the surface under test, and by the Fourier analysis and the optical aberration theory we obtain the sagitta (elevation map) of the surface. Then, taking the first and the second derivatives of the sagitta in the radial direction we obtain the meridional curvature map. The method is illustrated with an example. To check the performance of the HT topographer a toric surface, a revolution aspherical surface, and two human corneas were measured. Our results are compared with those obtained with a Placido ring topographer (Tomey TMS-4 videokeratoscope), and we show that our curvature maps are similar to those obtained with the Placido ring topographer. The HT topographer is able to reconstruct the corneal topography potentially eradicating the skew ray problem, therefore, corneal defects can be visualized more. The results are presented by elevation and meridional curvature maps.

  18. Tolerance of Micronized Mineral Pigments for Intrastromal Keratopigmentation: A Histopathology and Immunopathology Experimental Study. (United States)

    Amesty, Maria A; Rodriguez, Alejandra E; Hernández, Enrique; De Miguel, Maria P; Alio, Jorge L


    To study the tolerance and biocompatibility of mineral pigments for corneal pigmentation histopathologically and immunologically in an experimental animal model. Manual intralamellar keratopigmentation was performed in 28 New Zealand white rabbits using micronized mineral pigments. Histopathological examination was performed 3 months after the surgery to determine the level of pigment diffusion, the level of inflammation, and the presence/absence of neovascularization. An immunological analysis was also performed. No pigment diffusion or changes in color, inflammation, or neovascularization were detected in the treated eyes. Histopathological examination corroborated clinical results regarding inflammation. Pigmented corneas showed a good cosmetic appearance without signs of ocular toxicity. From the immunological perspective, the pigments do not generate an inflammatory response in the rabbit cornea or in vitro. Micronized mineral pigments could be a valid alternative treatment for corneal pigmentation. Manual intralamellar keratopigmentation technique presented good cosmetic appearance without adverse effects in the treated eyes.

  19. Angiopoietin 2 expression in the cornea and its control of corneal neovascularisation. (United States)

    Ferrari, Giulio; Giacomini, Chiara; Bignami, Fabio; Moi, Davide; Ranghetti, Anna; Doglioni, Claudio; Naldini, Luigi; Rama, Paolo; Mazzieri, Roberta


    To define proangiogenic angiopoietin 2 (ANG2) expression and role(s) in human and mouse vascularised corneas. Further, to evaluate the effect of ANG2 inhibition on corneal neovascularisation (CNV). CNV was induced in FVB mice by means of intrastromal suture placement. One group of animals was sacrificed 10 days later; corneas were immunostained for ANG2 and compared with (i) mouse non-vascularised corneas and (ii) human vascularised and non-vascularised corneas. A second group of CNV animals was treated systemically with an anti-ANG2 antibody. After 10 days, the corneas were whole-mounted, stained for CD31 and LYVE1 and lymphatic/blood vessels quantified. In another set of experiments, the corneal basal Bowman membrane was either (i) removed or (ii) left in place. After 2 or 10 days the corneas were removed and immunostained for collagen IV, ANG2, CD31, LYVE1, CD11b and MRC1 markers. In human beings and mice, ANG2 is expressed only in the epithelium, and, mildly, in the endothelium, of the avascular cornea. Instead, it is expressed in the epithelium, endothelium and stroma of vascularised corneas. Disruption of the Bowman membrane is associated with a significant increase of (i) ANG2 stromal expression and (ii) proangiogenic macrophage infiltration in the corneal stroma. Finally, blocking ANG2 significantly reduced hemangiogenesis, lymphangiogenesis and macrophage infiltration. Balancing proper healing and good vision is crucial in the cornea, constantly exposed to potential injuries. In this paper, we suggest the existence of a mechanism regulating the onset of inflammation (and associated CNV) depending on injury severity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  20. Human corneal epithelial subpopulations

    DEFF Research Database (Denmark)

    Søndergaard, Chris Bath


    subpopulations in human corneal epithelium using a combination of laser capture microdissection and RNA sequencing for global transcriptomic profiling. We compared dissociation cultures, using either expansion on γ-irradiated NIH/3T3 feeder cells in serum-rich medium or expansion directly on plastic in serum......-free EpiLife medium, using a range of physiologically relevant oxygen concentrations (2%, 5%, 10%, 15% and 20%). Using immunocytochemistry and advanced fluorescence microscopy, cells were characterized regarding growth, cell cycle distribution, colony-forming efficiency (CFE), phenotypes...... was not dependent on the system used for propagation (Bath et al. 2013a). Laser capture microdissection was used to isolate cellular subpopulations in situ from the spatially defined differentiation pathway in human corneal epithelium according to an optimized protocol for maintenance of expression profiles...

  1. Contact Lens Related Corneal Ulcer


    Loh, KY; Agarwal, P


    A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are: overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. Th...

  2. Dynamic corneal deformation response and integrated corneal tomography

    Directory of Open Access Journals (Sweden)

    Marcella Q Salomão


    Full Text Available Measuring corneal biomechanical properties is still challenging. There are several clinical applications for biomechanical measurements, including the detection of mild or early forms of ectatic corneal diseases. This article reviews clinical applications for biomechanical measurements provided by the Corvis ST dynamic non contact tonometer

  3. Dynamic corneal deformation response and integrated corneal tomography (United States)

    Salomão, Marcella Q; Hofling-Lima, Ana Luisa; Faria-Correia, Fernando; Lopes, Bernardo Teixeira; Rodrigues-Barros, Sandra; Roberts, Cynthia J; Ambrósio, Renato


    Measuring corneal biomechanical properties is still challenging. There are several clinical applications for biomechanical measurements, including the detection of mild or early forms of ectatic corneal diseases. This article reviews clinical applications for biomechanical measurements provided by the Corvis ST dynamic non contact tonometer PMID:29480246

  4. Genetics of corneal endothelial dystrophies

    Indian Academy of Sciences (India)


    Dec 31, 2009 ... Kallam Anji Reddy Molecular Genetics Laboratory, Prof Brien Holden Eye Research Centre,. L. V. Prasad Eye Institute, ... Keywords. genetics; corneal dystrophy; corneal endothelium; gene mapping; mutations. Journal of Genetics .... PPCD and autosomal dominant keratoconus (including ker- atoconus in ...

  5. Corneal Ectasia and Hydrops in Ocular Hypotony: The Corneal Crease. (United States)

    Farooq, Asim V; Soin, Ketki; Williamson, Samantha; Joslin, Charlotte E; Cortina, Maria S; Tu, Elmer Y


    To report the association of chronic ocular hypotony with the development of progressive corneal ectasia and hydrops. Retrospective case series. Three patients with ocular hypotony were referred for corneal evaluation and found to have ectasia and acute corneal hydrops in their hypotonous eye(s). Clinically, the globes were easily deformable with either external digital palpation and/or simple blinking. All 3 patients had a history of chronic iridocyclitis, including one with juvenile idiopathic arthritis. In each case, the area of thinning was narrow and arcuate in configuration, distinctive from other ectatic disorders. Also uncharacteristically, the acute hydrops resolved rapidly within 2 to 3 weeks without surgical intervention. In 1 case, severe thinning with perforation occurred requiring urgent penetrating keratoplasty. This case series demonstrates a unique clinical entity in which corneal ectasia and hydrops developed in the setting of ocular hypotony and easily deformable corneas, in a pattern unlike previously described forms of ectasia. Acute hydrops, even with associated corneal perforation, demonstrated a short and self-limited course. Corneal ectasia and irregular astigmatism should be suspected as a cause of unexplained visual loss in the ever-increasing number of patients with chronic, stable ocular hypotony. Further study is warranted to determine the pathophysiology of corneal ectasia in this setting, which may include mechanical and inflammatory factors.

  6. Vortex rings

    CERN Document Server

    Akhmetov, D G


    This text on vortex rings covers their theoretical foundation, systematic investigations, and practical applications such as the extinction of fires at gushing oil wells. It pays special attention to the formation and motion of turbulent vortex rings.

  7. Femtosecond laser's application in the corneal surgery

    Directory of Open Access Journals (Sweden)

    Shu-Liang Wang


    Full Text Available With the rapid development over the past two decades,femtosecond(10-15slasers(FShas become a new application in ophthalmic surgery. As laser power is defined as energy delivered per unit time, decreasing the pulse duration to femtosecond level(100fsnot only increases the power delivered but also decreases the fluence threshold for laser induced optical breakdown. In ablating tissue, FS has an edge over nanosecond lasers as there is minimal collateral damage from shock waves and heat conduction during surgical ablation. Thus, application of FS has been widely spread, from flap creation for laser-assisted in situ keratomileusis(LASIKsurgery, cutting of donor and recipient corneas in keratoplasty, creation of pockets for intracorneal ring implantation. FS applied in keratoplasty is mainly used in making graft and recipient bed, and can exactly cut different tissue of keratopathy. FS can also cut partial tissue of cornea, even if it is under the moderate corneal macula and corneal edema condition.

  8. Corneal collagen cross-linking: ectasia and beyond. (United States)

    Suri, Kunal; Hammersmith, Kristin M; Nagra, Parveen K


    Corneal collagen cross-linking has recently emerged as a novel approach for management of ectasia. This article reviews the literature published in the past 3 years about the expanding spectrum of cross-linking as a therapeutic modality and its complications. Recent studies have confirmed the beneficial effects of cross-linking in stabilization and to a lesser extent, regression of keratoconus and postrefractive surgery ectasia. Other applications include cross-linking as a combined procedure with intracorneal ring segments, and photorefractive keratectomy for ectasia, corneal edema, and infectious keratitis. Animal studies of chemical cross-linking of sclera as a potential treatment for progressive myopia have also been performed. Various modifications of the technique to increase the safety profile of cross-linking have been reported, including the use of hypoosmolar riboflavin, transepithelial cross-linking, customized epithelial debridement, and higher fluence shorter duration ultraviolet A light exposure. Reported complications include keratitis, corneal haze, endothelial cell loss and failure of treatment. Cross-linking has been shown to be an effective modality for corneal ectasia, the regression being less in patients with postrefractive ectasia than keratoconus. In a few studies, it has been found to be effective in symptomatic improvement of bullous keratopathy, and infectious keratitis but further studies are required. Cross-linking with epithelial debridement is found to be most effective but various modifications are being investigated for an improved, and better safety outcome.

  9. Localized changes in stromal reflectivity after corneal collagen cross-linking observed with different imaging techniques. (United States)

    Wittig-Silva, Christine; Chan, Elsie; Pollock, Graeme; Snibson, Grant R


    To report changes observed in the corneal stroma using confocal microscopy and Scheimpflug imaging following epithelium-off collagen cross-linking (CXL) in cases of progressive keratoconus. Fifteen eyes of 14 patients were examined before and after CXL using slit-lamp biomicroscopy, Scheimpflug imaging, and confocal microscopy. A subset of patients also had optical coherence tomography imaging performed. After CXL, confocal microscopy revealed a discrete layer of increased reflectivity in the mid to deep stroma. This layer was visible from as early as 1 week following treatment with patchy changes persisting until 12 months. This posterior reflective zone was found to consist of numerous linear or striate reflective structures (intrastromal striate reflections [ISRs]). ISRs were not observed in any of the eyes before the CXL procedure. High-resolution Scheimpflug and optical coherence tomography images also demonstrated a narrow zone of increased reflectivity at a similar depth. A layer-by-layer match was possible between the confocal and Scheimpflug images. The location of the ISR layer appears to correlate with a zone of increased reflectivity visible on postoperative slit-lamp examinations. Altered stromal reflectivity after CXL can be observed with modern diagnostic imaging technologies. These findings seem to correlate not only among the different devices but also with biomicroscopic observations and could potentially provide a non-invasive tool to monitor the cross-linking effect in individual corneas. Copyright 2013, SLACK Incorporated.

  10. Effects of femtosecond and excimer lasers on implanted KAMRA corneal inlay in animal models. (United States)

    Sammouh, F K; Baban, T A; Dandan, W N; Warrak, E L


    To evaluate the effect of femtosecond laser and excimer laser on an intracorneal inlay (KAMRA ® ) implanted in animal models. Femtosecond laser was used to create corneal intrastromal pockets at 250μm depth in five porcine eyes. Four intact KAMRA inlays, examined by slit-lamp biomicroscopy and light microscopy, were implanted in the pocket of four eyes. A standard LASIK flap was created above each implanted inlay in the four eyes using a femtosecond laser with flap thicknesses of 150μm, 130μm, 110μm and 90μm. In the fifth porcine eye, a LASIK flap was created using femtosecond laser at 110μm depth, and a fifth inlay was then implanted in the 250μm pocket. Excimer laser ablation was performed under the flap targeting a -3.00 refraction. The inlay was then explanted, examined and reimplanted in the same pocket followed by a second similar excimer laser ablation. Significant burn, shrinkage and distortion of microholes were noted in all the first four inlays following the femtosecond laser flap creation at all the various flap thicknesses. The damage was noted to be more prominent as the distance between the flap and inlay decreased. No apparent effect was noted on the fifth inlay following repeated excimer laser ablations. Unlike excimer laser, femtosecond laser appears to be hazardous and damaging to the intracorneal KAMRA inlay when applied above it. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. The Impact of Type 1 Diabetes Mellitus on Corneal Epithelial Nerve Morphology and the Corneal Epithelium


    Cai, Daniel; Zhu, Meifang; Petroll, W. Matthew; Koppaka, Vindhya; Robertson, Danielle M.


    Diabetic corneal neuropathy can result in chronic, sight-threatening corneal pathology. Although the exact etiology is unknown, it is believed that a reduction in corneal sensitivity and loss of neurotrophic support contributes to corneal disease. Information regarding the relationship between nerve loss and effects on the corneal epithelium is limited. We investigated changes in the corneal epithelium and nerve morphology using three-dimensional imaging in vivo and in situ in a streptozotoci...

  12. Planetary Rings (United States)

    Tiscareno, Matthew S.

    Planetary rings are the only nearby astrophysical disks and the only disks that have been investigated by spacecraft (especially the Cassini spacecraft orbiting Saturn). Although there are significant differences between rings and other disks, chiefly the large planet/ring mass ratio that greatly enhances the flatness of rings (aspect ratios as small as 10- 7), understanding of disks in general can be enhanced by understanding the dynamical processes observed at close range and in real time in planetary rings.We review the known ring systems of the four giant planets, as well as the prospects for ring systems yet to be discovered. We then review planetary rings by type. The A, B, and C rings of Saturn, plus the Cassini Division, comprise our solar system's only dense broad disk and host many phenomena of general application to disks including spiral waves, gap formation, self-gravity wakes, viscous overstability and normal modes, impact clouds, and orbital evolution of embedded moons. Dense narrow rings are found both at Uranus (where they comprise the main rings entirely) and at Saturn (where they are embedded in the broad disk) and are the primary natural laboratory for understanding shepherding and self-stability. Narrow dusty rings, likely generated by embedded source bodies, are surprisingly found to sport azimuthally confined arcs at Neptune, Saturn, and Jupiter. Finally, every known ring system includes a substantial component of diffuse dusty rings.Planetary rings have shown themselves to be useful as detectors of planetary processes around them, including the planetary magnetic field and interplanetary impactors as well as the gravity of nearby perturbing moons. Experimental rings science has made great progress in recent decades, especially numerical simulations of self-gravity wakes and other processes but also laboratory investigations of coefficient of restitution and spectroscopic ground truth. The age of self-sustained ring systems is a matter of

  13. [Methods for sealing of corneal perforations]. (United States)

    Samoilă, O; Totu, Lăcrămioara; Călugăru, M


    A variety of corneal pathology can lead to corneal ulcers and perforations. A deep corneal ulcer may need surgical treatment to allow good volume restoration and reepithelisation. Corneal perforation must be sealed and when the perforation is large, the task of repairing the defect can be underwhelming. The elegant solution is the corneal transplant, but this is not always readily available, especially in undeveloped countries. We present here two cases with different solutions to seal the perforated cornea: the first one has a large peripheral defect and it is successfully sealed with scleral patch and the second one is central with small perforation and is successfully sealed with multilayered amniotic membrane. Both cases are followed for over 12 months and demonstrate good corneal restoration (both on clinical examination and corneal topography). Sclera and amniotic membrane can be used to seal corneal defects when corneal transplant is not readily available.

  14. A steep peripheral ring in irregular cornea topography, real or an instrument error? (United States)

    Galindo-Ferreiro, Alicia; Galvez-Ruiz, Alberto; Schellini, Silvana A; Galindo-Alonso, Julio


    To demonstrate that the steep peripheral ring (red zone) on corneal topography after myopic laser in situ keratomileusis (LASIK) could possibly due to instrument error and not always to a real increase in corneal curvature. A spherical model for the corneal surface and modifying topography software was used to analyze the cause of an error due to instrument design. This study involved modification of the software of a commercially available topographer. A small modification of the topography image results in a red zone on the corneal topography color map. Corneal modeling indicates that the red zone could be an artifact due to an instrument-induced error. The steep curvature changes after LASIK, signified by the red zone, could be also an error due to the plotting algorithms of the corneal topographer, besides a steep curvature change.

  15. Corneal densitometry as an indicator of corneal health. (United States)

    Otri, Ahmad Muneer; Fares, Usama; Al-Aqaba, Mouhamed A; Dua, Harminder S


    To establish prospectively the normal values of corneal density of healthy subjects using the Pentacam Scheimpflug system (Oculus, Inc., Wetzlar, Germany) and to investigate alteration in corneal density during active and healed stages of bacterial keratitis. Prospective, comparative case series. Sixty-four eyes of 40 healthy controls and 36 eyes of 35 patients with bacterial keratitis were studied. This study was conducted at the Queen's Medical Centre, Nottingham, United Kingdom. A Pentacam system was used to study corneal density. Corneal densitometry readings in subjects with bacterial keratitis were recorded during the active stage and 4 to 6 weeks after complete healing. Densitometry was recorded at the site of infection and at a point in clear cornea furthest away from the infectious infiltrate. Corneal thickness also was measured. Densitometry values of normal cornea, at the site of corneal ulcer or abscess, and at a distant point of clear cornea during active and healed keratitis. The mean densitometry value of normal corneas was 12.3 ± 2.4. In infectious keratitis, the densitometry values were greatest at the site of the active infection and significantly more than in controls. The densitometry values at the points of clear cornea furthest away from the site of infection also were significantly higher than in controls during active disease, but failed to return to normal values, despite complete resolution of infection. The density of the infiltrates was much higher than that of residual scars after healing of ulcers. No correlation was found between the pachymetry and the densitometry values. Densitometry of active infectious corneal infiltrates is more than that resulting from the corneal scarring after healing. Persistent increase in density of clear cornea furthest away from the focus of corneal infection suggests that the host response extends beyond the immediate area of infection and indeed may occur through the entire cornea. These changes


    Directory of Open Access Journals (Sweden)



    Full Text Available A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are:overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. The presenting symptoms of contact lens related corneal ulcers include eye discomfort, foreign body sensation and lacrimation. More serious symptoms are redness (especially circum-corneal injection, severe pain, photophobia, eye discharge and blurring of vision. The diagnosis is established by a thorough slit lamp microscopic examination with fluorescein staining and corneal scraping for Gram stain and culture of the infective organism. Delay in diagnosing and treatment can cause permanent blindness, therefore an early referral to ophthalmologist and commencing of antimicrobial therapy can prevent visual loss.

  17. Corneal Confocal Microscopy Detects Corneal Nerve Damage in Patients Admitted With Acute Ischemic Stroke. (United States)

    Khan, Adnan; Akhtar, Naveed; Kamran, Saadat; Ponirakis, Georgios; Petropoulos, Ioannis N; Tunio, Nahel A; Dargham, Soha R; Imam, Yahia; Sartaj, Faheem; Parray, Aijaz; Bourke, Paula; Khan, Rabia; Santos, Mark; Joseph, Sujatha; Shuaib, Ashfaq; Malik, Rayaz A


    Corneal confocal microscopy can identify corneal nerve damage in patients with peripheral and central neurodegeneration. However, the use of corneal confocal microscopy in patients presenting with acute ischemic stroke is unknown. One hundred thirty patients (57 without diabetes mellitus [normal glucose tolerance], 32 with impaired glucose tolerance, and 41 with type 2 diabetes mellitus) admitted with acute ischemic stroke, and 28 age-matched healthy control participants underwent corneal confocal microscopy to quantify corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length. There was a significant reduction in corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length in stroke patients with normal glucose tolerance ( P diabetes mellitus ( P nerve fiber density ( r =-0.187, P =0.03; r =-0.229 P =0.01), corneal nerve fiber length ( r =-0.228, P =0.009; r =-0.285; P =0.001), and corneal nerve branch density ( r =-0.187, P =0.033; r =-0.229, P =0.01). Multiple linear regression showed no independent associations between corneal nerve fiber density, corneal nerve branch density, and corneal nerve fiber length and relevant risk factors for stroke. Corneal confocal microscopy is a rapid noninvasive ophthalmic imaging technique that identifies corneal nerve fiber loss in patients with acute ischemic stroke. © 2017 American Heart Association, Inc.

  18. Keratoconus (United States)

    ... 16C. Kojima T, Primack JD, Azar DT. Intrastromal corneal ring segments and collagen crosslinking. In: Yanoff M, Duker JS, eds. Ophthalmology . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3.9. Sugar J, Batta P. Keratoconus and other ectasias. In: Yanoff M, Duker JS, eds. Ophthalmology . 4th ...

  19. Visual rehabilitation and outcomes for ectasia after corneal refractive surgery. (United States)

    Woodward, Maria A; Randleman, J Bradley; Russell, Buddy; Lynn, Michael J; Ward, Michael A; Stulting, R Doyle


    To analyze the visual outcomes and method of final visual correction in eyes with corneal ectasia after laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Emory University Department of Ophthalmology and Emory Vision, Atlanta, Georgia, USA. This retrospective review comprised 74 eyes of 45 patients with corneal ectasia after LASIK (72 eyes) or PRK (2 eyes). Outcomes included postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best corrected visual acuity (BCVA), and refraction; method of final visual correction; and time to rigid gas-permeable (RGP) contact lens failure. Corneal ectasia developed a mean of 19.2 months after surgery. Postoperatively, the mean UCVA was 20/400 and the mean BSCVA before ectasia management was 20/108. After ectasia management, the mean BCVA was 20/37 and the final BCVA was 20/40 or better in 78% of eyes. Final visual correction was achieved with RGP lenses in 77% of eyes, spectacles in 9%, collagen crosslinking in 3%, intracorneal ring segments in 1%, and penetrating keratoplasty (PKP) in 8%. Two eyes with intracorneal ring segments required segment explantation and subsequent PKP. One eye that had PKP had a graft-rejection episode; there were no graft failures. Two eyes (3%) did not require a visual device to improve visual acuity. The mean time for successful RGP lens wear was 24.8 months; 80% of cases initially managed with RGP lenses were successful with this form of treatment. The majority of eyes developing postoperative corneal ectasia achieved functional visual acuity with RGP lens wear and did not require further intervention. Penetrating keratoplasty can usually be postponed or avoided by alternative methods of visual rehabilitation; however, PKP, when necessary, can provide good visual outcomes.

  20. Corneal topography indices after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results. (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Peter S


    To evaluate changes in corneal topography indices after corneal collagen crosslinking (CXL) in patients with keratoconus and corneal ectasia and analyze associations of these changes with visual acuity. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal collagen crosslinking was performed in eyes with keratoconus or ectasia. Quantitative descriptors of corneal topography were measured with the Pentacam topographer and included 7 indices: index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, minimum radius of curvature, index of height asymmetry, and index of height decentration. Follow-up was 1 year. The study comprised 71 eyes, 49 with keratoconus and 22 with post-LASIK ectasia. In the entire patient cohort, there were significant improvements in the index of surface variance, index of vertical asymmetry, keratoconus index, and minimum radius of curvature at 1 year compared with baseline (all P ectasia subgroups. Improvements in postoperative indices were not correlated with changes in corrected or uncorrected distance visual acuity. There were improvements in 4 of 7 topography indices 1 year after CXL, suggesting an overall improvement in corneal shape. However, no significant correlation was found between the changes in individual topography indices and changes in visual acuity after CXL. Copyright © 2011. Published by Elsevier Inc.

  1. Corneal thickness changes after corneal collagen crosslinking for keratoconus and corneal ectasia: one-year results. (United States)

    Greenstein, Steven A; Shah, Vinnie P; Fry, Kristen L; Hersh, Peter S


    To determine the changes in corneal thickness over time after corneal collagen crosslinking (CXL) for keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Corneal thickness at the apex, thinnest point, and pupil center were measured using Scheimpflug imaging (Pentacam) at baseline and 1, 3, 6, and 12 months after CXL. The treatment group was compared with both a sham-procedure control group and a fellow-eye control group. Associations with clinical outcomes (uncorrected and corrected distance visual acuities and maximum keratometry) were analyzed. The study comprised 82 eyes, 54 with keratoconus and 28 with ectasia after laser in situ keratomileusis. The mean preoperative thinnest pachymetry was 440.7 μm ± 52.9 (SD). After CXL, the cornea thinned at 1 month (mean change -23.8 ± 28.7 μm; Pcorneal thickness between 3 months and 6 months (mean +20.5 ± 20.4 μm; Pcorneal thickness was more rapid in ectasia than in keratoconus. There was no association between the degree of corneal thinning at 3 months and clinical outcomes after CXL. After CXL, the cornea thins and then recovers toward baseline thickness. The cause and implications of corneal thickness changes after CXL remain to be elucidated. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Corneal Sparing Conjunctival Abrasion

    Directory of Open Access Journals (Sweden)

    Hamid Ehsani-Nia


    Full Text Available History of present illness: A 15-year-old male was transported to the emergency department via ambulance as a trauma activation after being struck by an automobile while jogging. Patient was alert and oriented, with no focal neurological deficits and no loss of consciousness. The patient complained of right eye foreign body sensation. Significant findings: Physical exam was significant for multiple broken teeth, multiple minor abrasions on the face, and fine shards of shattered glass on his face and hair. His right eye had conjunctival injection, with no signs of subconjunctival hemorrhage or ocular penetration. Vision, extraocular movement, and pupillary exam were grossly intact. Fluorescein staining with slit lamp exam with cobalt blue filter examination of the right eye revealed superficial bulbar conjunctival uptake of fluorescein dye staining an area of the conjunctiva inferior to the limbus 5 mm vertical by 2 mm horizontal (estimation by photo provided. No foreign bodies were visualized in the inferior fornix. These findings were consistent with superficial conjunctival abrasion. The exam noted sparing of the corneal epithelium. Discussion: The conjunctiva is a thin, transparent membrane covering the ocular surface from the corneal limbus to the posterior eyelid margin.1 When damaged, the patient will classically have a “foreign body” sensation. It is important to identify the extent of the injury as not extending over the cornea, and also to search for lodged foreign bodies that damage the conjunctiva further with each blink. Classically retained foreign bodies will form a linear and vertical pattern of staining with fluorescein.2,3 Fluorescein stains expose basement membrane and fluoresces bright green under ultraviolet light, thus indicating areas of damage in contrast to its surrounding tissue.4,5 In the setting of acute trauma, urgent Ophthalmologic consultation is indicated if there is anterior chamber hemorrhage, a ruptured or

  3. Corneal stromal dystrophies: a clinical pathologic study

    Directory of Open Access Journals (Sweden)

    Elvira Barbosa Abreu


    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  4. Storage rings

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, Gerald K.


    The development of storage rings is discussed. Advantages of such devices are pointed out as well as their limits, requirements, and design and fabrication problems. Information gained by the operation of small electron storage rings is included, and three experiments are proposed for colliding-beam facilities. (D.C.W.)

  5. Quiste dermoide corneal bilateral

    Directory of Open Access Journals (Sweden)

    Michel Guerra Almaguer

    Full Text Available El dermoide es un tipo de coristoma (tejido embrionario normal en una localización anormal que afecta con frecuencia la córnea. Aparece como una masa sólida, blanca, redonda y elevada. Suele localizarse en el limbo inferotemporal, aunque puede hacerlo en cualquier lugar del globo ocular o de la órbita. Se presenta un paciente masculino, de 8 años de edad, quien desde su nacimiento muestra una mancha blanca en ambos ojos, agudeza visual sin corrección de movimiento de mano a 33 centímetros en el ojo derecho y percepción luminosa en el ojo izquierdo. En la exploración oftalmológica de ambos ojos se apreciaron lesiones blanquecinas sobre la córnea. Se le realizó exéresis del quiste y queratoplastia lamelar de ambos ojos, con resultados visuales satisfactorios. Se concluye que el caso presenta un quiste dermoide corneal bilateral.

  6. Management of a Small Paracentral Corneal Perforation Using Iatrogenic Iris Incarceration and Tissue Adhesive

    Directory of Open Access Journals (Sweden)

    Akira Kobayashi


    Full Text Available Background: Surgical intervention for corneal perforation is indicated when the anterior chamber does not reform within a short period of time. Herein, we report the successful management of a small paracentral corneal perforation using autologous iris incarceration and tissue adhesive. Case: A 41-year-old man developed a small paracentral corneal perforation (0.5 mm in size in the right eye, while the treating physician attempted to remove the residual rust ring after removal of a piece of metallic foreign body. Observations: The eye was initially managed with a bandage soft contact lens to ameliorate the aqueous leakage; however, without success. Iatrogenic iris incarceration of the wound was first induced, followed by application of cyanoacrylate tissue adhesive to the perforated site. As a result, the anterior chamber was immediately reformed and maintained. Complete corneal epithelialization of the perforation was achieved in 2 months without visual compromises. Conclusions: Cyanoacrylate tissue adhesive with iatrogenic incarceration of the autologous iris was effective in treating this type of small corneal perforation. This technique is simple and potentially useful for small paracentral corneal perforations outside the visual axis and without good apposition.

  7. Progress of research on corneal collagen cross-linking for corneal melting

    Directory of Open Access Journals (Sweden)

    Ke-Ren Xiao


    Full Text Available Corneal collagen cross-linking(CXLcould increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet-A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet-A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.

  8. Corneal neovascularization and biological therapy. (United States)

    Voiculescu, O B; Voinea, L M; Alexandrescu, C


    Corneal avascularity is necessary for the preservation of optimal vision. The cornea maintains a dynamic balance between pro- and antiangiogenic factors that allows it to remain avascular under normal homeostatic conditions. Corneal neovascularization (NV) is a condition that can develop in response to inflammation, hypoxia, trauma, or limbal stem cell deficiency and it is a significant cause of blindness. New therapeutic options for diseases of the cornea and ocular surface are now being explored in experimental animals and clinical trials. Antibody based biologics are being tested for their ability to reduce blood and lymphatic vessel ingrowth into the cornea, and to reduce inflammation. Numerous studies have shown that biologics with specificity for VEGF A such as bevacizumab and ranibizumab (a recombinant antibody and an antibody fragment, respectively) or anti-tumor necrosis factor-α microantibody, are effective in the treatment of corneal neovascularization.

  9. Acute corneal hydrops in keratoconus

    Directory of Open Access Journals (Sweden)

    Prafulla K Maharana


    Full Text Available Acute corneal hydrops is a condition characterized by stromal edema due to leakage of aqueous through a tear in descemet membrane. The patient presents with sudden onset decrease in vision, photophobia, and pain. Corneal thinning and ectasias combined with trivial trauma to the eye mostly by eye rubbing is considered as the underlying cause. With conservative approach self-resolution takes around 2 to 3 months. Surgical intervention is required in cases of non-resolution of corneal edema to avoid complications and for early visual rehabilitation. Intracameral injection of air or gas such as perflouropropane is the most common surgical procedure done. Recent investigative modality such as anterior segment optical coherence tomography is an extremely useful tool for diagnosis, surgical planning, and postoperative follow up. Resolution of hydrops may improve the contact lens tolerance and visual acuity but most cases require keratoplasty for visual rehabilitation.

  10. Ocular dimensions, corneal thickness, and corneal curvature in quarter horses with hereditary equine regional dermal asthenia. (United States)

    Badial, Peres R; Cisneros-Àlvarez, Luis Emiliano; Brandão, Cláudia Valéria S; Ranzani, José Joaquim T; Tomaz, Mayana A R V; Machado, Vania M; Borges, Alexandre S


    The aim of this study was to compare ocular dimensions, corneal curvature, and corneal thickness between horses affected with hereditary equine regional dermal asthenia (HERDA) and unaffected horses. Five HERDA-affected quarter horses and five healthy control quarter horses were used. Schirmer's tear test, tonometry, and corneal diameter measurements were performed in both eyes of all horses prior to ophthalmologic examinations. Ultrasonic pachymetry was performed to measure the central, temporal, nasal, dorsal, and ventral corneal thicknesses in all horses. B-mode ultrasound scanning was performed on both eyes of each horse to determine the dimensions of the ocular structures and to calculate the corneal curvature. Each corneal region examined in this study was thinner in the affected group compared with the healthy control group. However, significant differences in corneal thickness were only observed for the central and dorsal regions. HERDA-affected horses exhibited significant increases in corneal curvature and corneal diameter compared with unaffected animals. The ophthalmologic examinations revealed mild corneal opacity in one eye of one affected horse and in both eyes of three affected horses. No significant between-group differences were observed for Schirmer's tear test, intraocular pressure, or ocular dimensions. Hereditary equine regional dermal asthenia-affected horses exhibit decreased corneal thickness in several regions of the cornea, increased corneal curvature, increased corneal diameter, and mild corneal opacity. Additional research is required to determine whether the increased corneal curvature significantly impacts the visual accuracy of horses with HERDA. © 2014 American College of Veterinary Ophthalmologists.

  11. Progress in corneal wound healing (United States)

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh


    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  12. Determinantal rings

    CERN Document Server

    Bruns, Winfried


    Determinantal rings and varieties have been a central topic of commutative algebra and algebraic geometry. Their study has attracted many prominent researchers and has motivated the creation of theories which may now be considered part of general commutative ring theory. The book gives a first coherent treatment of the structure of determinantal rings. The main approach is via the theory of algebras with straightening law. This approach suggest (and is simplified by) the simultaneous treatment of the Schubert subvarieties of Grassmannian. Other methods have not been neglected, however. Principal radical systems are discussed in detail, and one section is devoted to each of invariant and representation theory. While the book is primarily a research monograph, it serves also as a reference source and the reader requires only the basics of commutative algebra together with some supplementary material found in the appendix. The text may be useful for seminars following a course in commutative ring theory since a ...

  13. ring system

    African Journals Online (AJOL)

    1,3,2-DIAZABORACYCLOALKANE. RING SYSTEM. Negussie Retta" and Robert H. Neilson. 'Department of Chemistry, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia. Department of Chemistry, Texas Christian University.

  14. Vascular ring (United States)

    ... trachea) and esophagus can lead to breathing and digestive problems. The more the ring presses down, the more severe the symptoms will be. Breathing problems may include: ... Digestive symptoms are rare, but may include: Choking Difficulty ...

  15. [Results of corneal crosslinking for pellucid marginal corneal degeneration]. (United States)

    Bikbov, M M; Surkova, V K; Khalimov, A R; Usubov, E L

    to evaluate the clinical effectiveness of crosslinking in patients with progressive pellucid marginal corneal degeneration (PMCD). A total of 9 patients (16 eyes) with progressive PMCD were treated by standard crosslinking. The cornea was saturated with Dextralink solution and UV-A irradiated at 3 mW/cm2 for 30 minutes. The follow-up period was 12 months. One month after treatment, there was a slight decrease in uncorrected and best corrected visual acuity (UCVA and BCVA) - from 0.08±0.03 and 0.4±0.15 preoperatively down to 0.06±0.02 and 0.3±0.07, respectively, caused by pseudohaze of the cornea. Keratometric parameters (the average refractive power of the cornea, corneal astigmatism, and corneal thickness) did not change significantly. The demarcation line was identified in 56% of cases. By the 3-month follow-up, UCVA and BCVA improved up to 0.1±0.07 and 0.52±0.1, respectively. The refractive power of the cornea decreased by 2.0 diopters and corneal astigmatism - by 0.7 diopters reaching 46.8±2.7 and 5.1±1.3 diopters, respectively (p≤0.04). Central corneal thickness decreased by an average of 29 microns. The demarcation line remained visible in 25% of cases. At 6 months, BCVA averaged 0.58±0.13, at that, 56% of eyes gained 1 line and 31% - 2 lines. The refractive power of the cornea decreased down to 45.7±1.6 diopters, corneal astigmatism - down to 4.8±1.5 diopters. The demarcation line was not detected. At 1 year, there were no significant changes in the average values of optometric indices as compared to the 6-month period. Сonclusion. Pellucid marginal corneal degeneration should be regarded as a kind of primary ectasia, often bilateral and notable for its characteristic clinical picture and late onset. In progressive disease, photochemical crosslinking of the cornea contributes to the improvement of optometric parameters and stabilization of the process.

  16. Corneal stroma microfibrils

    KAUST Repository

    Hanlon, Samuel D.


    Elastic tissue was first described well over a hundred years ago and has since been identified in nearly every part of the body. In this review, we examine elastic tissue in the corneal stroma with some mention of other ocular structures which have been more thoroughly described in the past. True elastic fibers consist of an elastin core surrounded by fibrillin microfibrils. However, the presence of elastin fibers is not a requirement and some elastic tissue is comprised of non-elastin-containing bundles of microfibrils. Fibers containing a higher relative amount of elastin are associated with greater elasticity and those without elastin, with structural support. Recently it has been shown that the microfibrils, not only serve mechanical roles, but are also involved in cell signaling through force transduction and the release of TGF-β. A well characterized example of elastin-free microfibril bundles (EFMBs) is found in the ciliary zonules which suspend the crystalline lens in the eye. Through contraction of the ciliary muscle they exert enough force to reshape the lens and thereby change its focal point. It is believed that the molecules comprising these fibers do not turn-over and yet retain their tensile strength for the life of the animal. The mechanical properties of the cornea (strength, elasticity, resiliency) would suggest that EFMBs are present there as well. However, many authors have reported that, although present during embryonic and early postnatal development, EFMBs are generally not present in adults. Serial-block-face imaging with a scanning electron microscope enabled 3D reconstruction of elements in murine corneas. Among these elements were found fibers that formed an extensive network throughout the cornea. In single sections these fibers appeared as electron dense patches. Transmission electron microscopy provided additional detail of these patches and showed them to be composed of fibrils (~10nm diameter). Immunogold evidence clearly


    African Journals Online (AJOL)


    Apr 10, 1971 ... At times one has had to improvise or temporize. cause the cornea to become taut, and in practice one ... In a donor eye the corneal surface flattens before the trephine and results in a trephine hole with sides ..... cornea that is clear and extends from just short of the central area to the limbus. In this way an ...

  18. PROSE treatment of corneal ectasia. (United States)

    Baran, Inna; Bradley, James A; Alipour, Fateme; Rosenthal, Perry; Le, Hong-Gam; Jacobs, Deborah S


    Prosthetic replacement of the ocular surface ecosystem (PROSE) uses custom designed and fabricated prosthetic devices in a treatment that restores vision, supports healing, reduces symptoms and improves quality of life in patients with complex corneal disease. We report the success rate for PROSE treatment of corneal ectasia. Records of 59 patients with corneal ectasia seen in consultation over 6 months were reviewed. Candidacy for treatment, topographic indices, change in visual acuity, achievement of satisfactory fit, device wear status and change in visual function at 6 months were recorded. Sixteen eyes were non-candidates because conventional correction was adequate. Trial devices were inserted but not dispensed for 13 eyes. No eyes were excluded for severity of ectasia. In the remaining 89 eyes, satisfactory fit was achieved and a device was dispensed. Twenty-one eyes (15 patients) had undergone penetrating keratoplasty. Device wear at 6 months was documented in 78/89 eyes (88%). NEI VFQ-25 score improved 27.6 points (pcorneal ectasia could be fitted with a PROSE device. PROSE treatment has a high success rate when measured by ability to achieve satisfactory fit, impact on visual acuity and 6 month data on both rate of continued wear and impact on visual function. PROSE treatment is an alternative to penetrating keratoplasty for patients with corneal ectasia who are contact lens intolerant. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. Corneal ectasia after photorefractive keratectomy. (United States)

    Leccisotti, Antonio


    Corneal ectasia after photorefractive keratectomy (PRK) has only been occasionally reported, and its incidence has not been assessed. In a retrospective, non-comparative case series, incidence of corneal ectasia was evaluated in a personal consecutive 6453-case series of myopic PRK with a minimum follow-up of 18 months. Features and prognosis were evaluated in all patients with ectasia after PRK (in both personal and referred cases). Ectasia was detected in three eyes of two patients (patients 1 and 2) 3 years and 1 year after PRK performed elsewhere. In addition, in the personal PRK series, two eyes of two patients (patients 3 and 4) developed corneal ectasia 5 months after surgery (incidence: 0.03%). Pre-operatively, forme fruste keratoconus was present in patients 1, 3 and 4; keratoconus in the fellow eye in patient 2; pachymetry corneal ectasia in predisposed eyes, even after low myopic ablations. Forme fruste keratoconus and keratoconus in the fellow eye were the main pre-operative findings. Prognosis varies according to severity.

  20. Management of corneal bee sting

    Directory of Open Access Journals (Sweden)

    Razmjoo H


    Full Text Available Hassan Razmjoo1,2, Mohammad-Ali Abtahi1,2,4, Peyman Roomizadeh1,3, Zahra Mohammadi1,2, Seyed-Hossein Abtahi1,3,41Medical School, Isfahan University of Medical Sciences (IUMS; 2Ophthalmology Ward, Feiz Hospital, IUMS; 3Isfahan Medical Students Research Center (IMSRC, IUMS; 4Isfahan Ophthalmology Research Center (IORC, Feiz Hospital, IUMS, Isfahan, IranAbstract: Corneal bee sting is an uncommon environmental eye injury that can result in various ocular complications with an etiology of penetrating, immunologic, and toxic effects of the stinger and its injected venom. In this study we present our experience in the management of a middle-aged male with a right-sided deep corneal bee sting. On arrival, the patient was complaining of severe pain, blurry vision with acuity of 160/200, and tearing, which he had experienced soon after the injury. Firstly, we administered conventional drugs for eye injuries, including topical antibiotic, corticosteroid, and cycloplegic agents. After 2 days, corneal stromal infiltration and edema developed around the site of the sting, and visual acuity decreased to 100/200. These conditions led us to remove the stinger surgically. Within 25 days of follow-up, the corneal infiltration decreased gradually, and visual acuity improved to 180/200. We suggest a two-stage management approach for cases of corneal sting. For the first stage, if the stinger is readily accessible or primary dramatic reactions, including infiltration, especially on the visual axis, exist, manual or surgical removal would be indicated. Otherwise, we recommend conventional treatments for eye injuries. Given this situation, patients should be closely monitored for detection of any worsening. If the condition does not resolve or even deteriorates, for the second stage, surgical removal of the stinger under local or generalized anesthesia is indicated.Keywords: bee sting, stinger, cornea, removal, management, surgery

  1. Ring accelerators

    International Nuclear Information System (INIS)

    Gisler, G.; Faehl, R.


    We present two-dimensional simulations in (r-z) and r-theta) cylinderical geometries of imploding-liner-driven accelerators of rings of charged particles. We address issues of azimuthal and longitudinal stability of the rings. We discuss self-trapping designs in which beam injection and extraction is aided by means of external cusp fields. Our simulations are done with the 2-1/2-D particle-in-cell plasma simulation code CLINER, which combines collisionless, electromagnetic PIC capabilities with a quasi-MHD finite element package

  2. Topological rings

    CERN Document Server

    Warner, S


    This text brings the reader to the frontiers of current research in topological rings. The exercises illustrate many results and theorems while a comprehensive bibliography is also included. The book is aimed at those readers acquainted with some very basic point-set topology and algebra, as normally presented in semester courses at the beginning graduate level or even at the advanced undergraduate level. Familiarity with Hausdorff, metric, compact and locally compact spaces and basic properties of continuous functions, also with groups, rings, fields, vector spaces and modules, and with Zorn''s Lemma, is also expected.

  3. Turning the tide of corneal blindness

    Directory of Open Access Journals (Sweden)

    Matthew S Oliva


    Full Text Available Corneal diseases represent the second leading cause of blindness in most developing world countries. Worldwide, major investments in public health infrastructure and primary eye care services have built a strong foundation for preventing future corneal blindness. However, there are an estimated 4.9 million bilaterally corneal blind persons worldwide who could potentially have their sight restored through corneal transplantation. Traditionally, barriers to increased corneal transplantation have been daunting, with limited tissue availability and lack of trained corneal surgeons making widespread keratoplasty services cost prohibitive and logistically unfeasible. The ascendancy of cataract surgical rates and more robust eye care infrastructure of several Asian and African countries now provide a solid base from which to dramatically expand corneal transplantation rates. India emerges as a clear global priority as it has the world′s largest corneal blind population and strong infrastructural readiness to rapidly scale its keratoplasty numbers. Technological modernization of the eye bank infrastructure must follow suit. Two key factors are the development of professional eye bank managers and the establishment of Hospital Cornea Recovery Programs. Recent adaptation of these modern eye banking models in India have led to corresponding high growth rates in the procurement of transplantable tissues, improved utilization rates, operating efficiency realization, and increased financial sustainability. The widespread adaptation of lamellar keratoplasty techniques also holds promise to improve corneal transplant success rates. The global ophthalmic community is now poised to scale up widespread access to corneal transplantation to meet the needs of the millions who are currently blind.

  4. Morphology and neurochemistry of canine corneal innervation. (United States)

    Marfurt, C F; Murphy, C J; Florczak, J L


    To determine the architectural pattern and neuropeptide content of canine corneal innervation. Corneal nerve fibers in normal dog eyes were labeled immunohistochemically with antibodies against protein gene product (PGP)-9.5, calcitonin gene-related peptide (CGRP), substance P (SP), vasoactive intestinal polypeptide (VIP), and tyrosine hydroxylase (TH). Relative innervation densities and distribution patterns for each fiber population were assessed qualitatively by serial line-drawing reconstructions and quantitatively by computer-assisted analyses. More than 99% of all corneal PGP-9.5-immunoreactive (IR) nerves contained both CGRP and SP, approximately 30% contained TH, and none contained VIP. Distribution patterns of corneal PGP-9.5-, CGRP-, SP-, and TH-IR nerves were indistinguishable, except that TH-IR fibers were absent from the corneal epithelium. Morphologically, canine corneal innervation consisted of a rich anterior stromal plexus, divided on the basis of morphologic criteria into anterior and posterior levels, and a rich epithelial innervation, characterized by large numbers of horizontally oriented, basal epithelial "leash" formations. Leash axons in all quadrants of the corneal epithelium oriented preferentially toward a common locus in the perilimbal cornea. The results of this study demonstrate for the first time the detailed architectural features, distinctive basal epithelial leash orientations, and peptidergic content of canine corneal innervation. The normal innervation pattern described in this study will provide other investigators with essential baseline data for assessing corneal nerve alterations in canine patients with spontaneous chronic corneal epithelial defects (SCCED) and other ocular diseases or injuries.

  5. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus. (United States)

    Mofty, Hanan; Alzahrani, Khaled; Carley, Fiona; Harper, Sophie; Brahma, Arun; Au, Leon; Morley, Debbie; Hillarby, M Chantal


    The purpose of this study was to assess UV corneal crosslinking (CXL) treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam. A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA) and maximum K -readings. In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV) and keratoconus index (KI) at 3 months and in the index of height asymmetry (IHA) and minimum radius of curvature ( R min ) at 9 months post treatment. On the contrary, the untreated group's indices showed some significant worsening in ISV, KI, central keratoconus index (CKI), and R min . A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA ( R 2 =0.390, p =0.053) and a strong correlation with maximum K -reading ( R 2 =0.690, p =0.005). However, the untreated group had no significant changes after 1 year. The corneal asymmetrical shape is associated with the spherical aberration alteration influenced by temporal evolution of surface ablation and increased corneal haze. However, insignificant changes in symmetry attest the stabilization effect on cornea postoperatively as compared with controls.

  6. Corneal Collagen Cross-linking for Treatment of Non-healing Corneal Ulcers. (United States)

    Zamani, Mitra; Panahi-Bazaz, Mahmoodreza; Assadi, Mona


    To evaluate the efficacy of corneal collagen cross-linking (CXL) for treatment of corneal ulcers not responding to antimicrobial therapy. Eight patients with corneal ulcers associated with corneal melting, not responding to conventional antibiotic therapy, were treated with CXL. The procedure was performed according to the standardized protocol for keratoconus. Preoperative medications were continued after CXL in all cases. Microbiological exams revealed Pseudomonas aeruginosa in 3 cases. Follow up continued from 1 to 10 months. In 6 of 8 eyes, progression of corneal melting was halted and complete epithelialization occurred. In one eye emergency keratoplasty was needed due to corneal perforation. A conjunctival flap was performed to treat severe localized corneal thinning in one of the patients a few days after CXL. Significant clinical improvement occurred in all cases of Pseudomonas aeruginosa keratitis. CXL can be considered as a promising new treatment in the management of refractory non-healing corneal ulcers, including Pseudomonas aeruginosa keratitis.

  7. Corneal cross-linking in the treatment of corneal ulcers. (United States)

    Price, Marianne O; Price, Francis W


    New treatments for corneal ulcers are needed to address challenges with antibiotic resistance, cost, and specificity requiring timely pathogen identification. This review assesses the evidence regarding safety and efficacy of corneal cross-linking (CXL) as an adjunct or stand-alone treatment. To date approximately 200 clinical cases of CXL used with various types of infectious keratitis have been reported in about 30 publications. Most employed the CXL protocol developed for keratoconus as an adjunct to antibiotics for resistant ulcers, and a number of cases resolved after this intervention. However, a few studies raised concerns about resurgence and perforation when CXL was utilized with deep fungal infections. The infiltrate depth is an important consideration, because the standard CXL treatment is cytotoxic (to keratocytes) to a depth of approximately 200-300 μm and 50% of the energy is absorbed within the first 100 μm. CXL was used successfully as a monotherapy in approximately 16 eyes with early bacterial or shallow fungal infections. Further work is needed to develop optimized CXL protocols for treatment of corneal ulcers, define the appropriate conditions for use, and determine the safety and efficacy relative to standard antibiotic treatments.

  8. Ring interferometry

    CERN Document Server

    Malykin, Grigorii B; Zhurov, Alexei


    This monograph is devoted to the creation of a comprehensive formalism for quantitative description of polarized modes' linear interaction in modern single-mode optic fibers. The theory of random connections between polarized modes, developed in the monograph, allows calculations of the zero shift deviations for a fiber ring interferometer. The monograph addresses also the

  9. Corneal collagen cross-linking for treatment of non-healing corneal ulcers


    Mitra Zamani; Mahmoodreza Panahi-Bazaz; Mona Assadi


    Purpose: To evaluate the efficacy of corneal collagen cross-linking (CXL) for treatment of corneal ulcers not responding to antimicrobial therapy. Methods: Eight patients with corneal ulcers associated with corneal melting, not responding to conventional antibiotic therapy, were treated with CXL. The procedure was performed according to the standardized protocol for keratoconus. Preoperative medications were continued after CXL in all cases. Microbiological exams revealed Pseudomonas aeru...

  10. Corneal Toxicity Following Exposure to Asclepias Tuberosa

    DEFF Research Database (Denmark)

    Mikkelsen, Lauge Hjorth; Hamoudi, Hassan; Gül, Cigdem Altuntas


    PURPOSE: To present a case of corneal toxicity following exposure to milky plant latex from Asclepias tuberosa. METHODS: A 70-year-old female presented with blurred vision and pain in her left eye after handling an Ascepias tuberosa. Clinical examination revealed a corneal stromal oedema with small...... that inhibit the Na+/ K+-ATPase in the corneal endothelium. The oedema resolved after 96 hours. After nine months the best corrected visual acuity was 20/20. CONCLUSION: Corneal toxicity has previously been reported for plants of the Asclepias family. This is a rare case describing severe corneal toxicity...... caused by exposure to latex from Asclepias tuberosa. Handling of plants of the Asclepias family should be kept as a differential diagnosis in cases of acute corneal toxicity....

  11. Corneal sensation after cataract and refractive surgery. (United States)

    Kohlhaas, M


    Most surgical procedures involving the anterior segment of the eye disrupt the normal organization of corneal innervation. Since denervation of the cornea results in impaired epithelial wound healing, increased epithelial permeability, decreased epithelial metabolic activity, and loss of cytoskeletal structures associated with cellular adhesion, it is important to identify the factors that determine the extent of neural regeneration. Mechanisms of corneal nerve damage and studies of corneal nerve fiber loss and reinnervation after cataract and refractive surgery--epikeratophakia, cryokeratomileusis, keratomileusis in situ, photorefractive keratectomy, laser in situ keratomileusis, and phacoemulsification--are reviewed and the decrease in corneal sensitivity, as a measure of corneal destruction and corneal metabolism, after these surgical procedures is compared.

  12. Topical thrombin-related corneal calcification. (United States)

    Kiratli, Hayyam; Irkeç, Murat; Alaçal, Sibel; Söylemezoğlu, Figen


    To report a highly unusual case of corneal calcification after brief intraoperative use of topical thrombin. A 44-year-old man underwent sclerouvectomy for ciliochoroidal leiomyoma, during which 35 UNIH/mL lyophilized bovine thrombin mixed with 9 mL of diluent containing 1500 mmol/mL calcium chloride was used. From the first postoperative day, corneal and anterior lenticular capsule calcifications developed, and corneal involvement slightly enlarged thereafter. A year later, 2 corneal punch biopsies confirmed calcification mainly in the Bowman layer. Topical treatment with 1.5% ethylenediaminetetraacetic acid significantly restored corneal clarity. Six months later, a standard extracapsular cataract extraction with intraocular lens placement improved visual acuity to 20/60. This case suggests that topical thrombin drops with elevated calcium concentrations may cause acute corneal calcification in Bowman layer and on the anterior lens capsule.

  13. Pharmacological treatment for infectious corneal ulcers. (United States)

    Miller, Darlene


    Cornea ulceration and infectious keratitis are leading causes of corneal morbidity and blindness. Infectious causes are among the most frequent and most severe. Management strategies for bacterial corneal ulcers have changed significantly over the last decades, however with a more limited progress in the treatment and management of nonbacterial, infectious ulcers. This paper provides an overview of the current principles, strategies and treatment choices for infectious corneal ulcers in adults. Topical application with a broad-spectrum antimicrobial remains the preferred method for the pharmacological management of infectious corneal ulcers. Increasing reports of clinical failures and in vitro resistance to antibiotics to treat the most common infectious (bacterial) corneal ulcers are increasing concerns. New approaches for improvement in the pharmacological management of corneal ulcers should focus on strategies for a more rational and evidence-based use of current antimicrobials and development of products to modulate the host immune response and to neutralize microbial toxins and other immune modulators.

  14. Immunoglobulins in granular corneal dystrophy Groenouw type I

    DEFF Research Database (Denmark)

    Møller, H U; Bojsen-Møller, M; Schrøder, H D


    Three patients with granular corneal dystrophy Groenouw type I underwent corneal grafting, and cryostat sections of the corneal buttons were examined immunohistochemically for immunoglobulins. Positive results were obtained for IgG, Kappa-, and Lambda chains with immunofluorescence technique...

  15. Effect of Lowering Laser Energy on the Surface Roughness of Human Corneal Lenticules in SMILE. (United States)

    Ji, Yong Woo; Kim, Minseo; Kang, David Sung Yong; Reinstein, Dan Z; Archer, Timothy J; Choi, Jin Young; Kim, Eung Kweon; Lee, Hyung Keun; Seo, Kyoung Yul; Kim, Tae-Im


    To determine the effect of lowering femtosecond laser energy on the surface quality of the intrastromal interface during small incision lenticule extraction (SMILE). Forty age- and diopter-matched female patients (40 eyes) with moderate myopia received SMILE with different energy levels (100 to 150 nJ) and fixed spot separation (4.5 μm). Five human corneal lenticules from each energy group were evaluated by atomic force microscopy and scanning electron microscopy (SEM). Both anterior and posterior surface characteristics of the lenticules were assessed. All measurements of surface roughness were approximately three times higher and in the anterior and posterior surface of the lenticules with the energy level of 150 nJ than with 100 nJ (P < .001). Furthermore, atomic force microscopy analysis found that energy differences of 15 nJ or more made a significant difference in surface roughness at energy levels of 115 nJ or higher. Interestingly, there was no significant difference in all roughness values of both surfaces among the 100, 105, and 110 nJ groups. In addition, all values of surface roughness were significantly positively correlated with laser energy for both anterior and posterior surfaces of the lenticule (P < .001). Consistent with atomic force microscopy results, SEM also showed that the SMILE lenticules in the higher laser energy group had more irregular surfaces. Lowering laser energy levels can improve surface quality of the lenticule of SMILE. To achieve better visual outcomes with faster recovery after the procedure, it is recommended to reduce the laser energy to less than 115 nJ at a spot separation of 4.5 μm. [J Refract Surg. 2017;33(9):617-624.]. Copyright 2017, SLACK Incorporated.

  16. Corneal hemangiosarcoma in a cat. (United States)

    Cazalot, G; Regnier, A; Deviers, A; Serra, F; Lucas, M N; Etienne, C L; Letron, I Raymond


    A 10 year-old castrated male Domestic Short-hair cat with a history of chronic bilateral keratitis was referred for assessment of a red, elevated mass involving the left cornea. The rapid growth of the mass, over a month period in combination with pronounced vascularization and invasion of the corneal surface suggested an aggressive inflammatory or neoplastic process. Following keratectomy, the lesion was diagnosed histopathologically as a hemangiosarcoma. The tumor recurred locally within 3 weeks and enucleation was performed. Histopathologic examination of the globe confirmed the diagnosis and did not reveal infiltration of the limbus and conjunctiva. No signs of local recurrence or metastatic disease have been observed 18 months following enucleation. To the authors' knowledge this is the first case of primary corneal hemangiosarcoma described in the feline species. © 2011 American College of Veterinary Ophthalmologists.

  17. Clinical research on corneal perforation

    Directory of Open Access Journals (Sweden)

    Cheng-Huan Dong


    Full Text Available AIM: To study the clinical characteristics of corneal perforation(CP.METHODS: A retrospective analysis in July 1995 to July 2010 the First Affiliated Hospital of Fujian Medical University diagnosed CP 72 patients(72 eyes, clinical characteristics of all the patients were analyzed. RESULTS: The incidence of corneal ulcer perforation rised year by year, the morbidity of male and female was 17:7, the onset age focused on 48 years old. Of 23 industrial workers(32%with clear history of trauma, pathogeny identification results: top two: fungal infection and Acanthamoeba keratitis. A using history of glucocorticoid was found in 10 cases. CONCLUSION: There are plenty of primary causes of CP such as traumas, fungal infection, Acanthamoeba keratitis, eroded keratitis, etc. CP happens in middle-aged males in Fujian province, most traumas are the causes, the main pathogenic bacteria is fungal infection.

  18. Evaluation of corneal symmetry after UV corneal crosslinking for keratoconus

    Directory of Open Access Journals (Sweden)

    Mofty H


    Full Text Available Hanan Mofty,1,2 Khaled Alzahrani,2 Fiona Carley,3 Sophie Harper,3 Arun Brahma,3 Leon Au,3 Debbie Morley,3 M Chantal Hillarby2 1Optometry Department, College of Applied Medical Science, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, 3Manchester Royal Eye Hospital, Manchester, UK Purpose: The purpose of this study was to assess UV corneal crosslinking (CXL treatment outcomes for keratoconus by evaluating the corneal regularity in patients through follow-up using the Oculus Pentacam.Patients and methods: A total of 18 eyes from CXL patients with keratoconus were studied before and after CXL treatment, and six eyes from six patients who were not treated with CXL served as controls. Treated patients had Pentacam images taken before CXL treatment and regularly 3 months post treatment up to the 12th month. Controls were imaged during their first appointment and after 12 months. Symmetry and asphericity were evaluated and correlated with both best-corrected visual acuity (BCVA and maximum K-readings.Results: In the CXL-treated group, there was a significant improvement in the index of symmetrical variation (ISV and keratoconus index (KI at 3 months and in the index of height asymmetry (IHA and minimum radius of curvature (Rmin at 9 months post treatment. On the contrary, the untreated group’s indices showed some significant worsening in ISV, KI, central keratoconus index (CKI, and Rmin. A novel finding in our study was a slight positive shift of anterior asphericity in the 6 mm, 7 mm, and 8 mm 3 months after treatment, which had a correlation with BCVA (R2=0.390, p=0.053 and a strong correlation with maximum K-reading (R2=0.690, p=0.005. However, the untreated group had no significant changes after 1 year.Conclusion: The corneal asymmetrical shape is associated with the spherical aberration alteration

  19. Haemophilus influenzae corneal ulcer in a therapeutic contact lens wearer.


    Armstrong, J. R.; Cohen, K. L.; McCarthy, L. R.


    Haemophilus influenzae is an unusual corneal pathogen and an unusual cause of corneal ulcers in Western society. In previous reports corneal complications from H. influenzae have been secondary to a conjunctivitis. The first case of a primary H. influenzae corneal ulcer as a complication of therapeutic contact lens wear is presented. Since other uncommon bacteria have been reported as causes of contact lens related corneal ulcers, the bacteriology of contact lens related corneal ulcers is rev...



    Padmaja; Nageswara Rao


    Corneal ulcers are the common cause of corneal blindness. Of the corneal ulcers, majority of the cases are because of the fungal etiology. The present study is aimed to identify the pathogenic organisms responsible for corneal infections. Majority of the cases are secondary to trauma. Of the fungal cases, Aspergillus is found to be the predominant fungus affecting corneal ulcers, followed by bacteria affecting the corneal ulcers.

  1. Organ transplantation scandal influencing corneal donation rate

    Directory of Open Access Journals (Sweden)

    Tobias Röck


    Full Text Available In the majority of countries, there is a shortage of donor corneas for corneal transplantations. This study investigated the impact of organ transplantation scandals on corneal donation rate at the University Hospital Tübingen. Each deceased patient was considered as a potential corneal donor. An ophthalmic resident handled with stable methods of procedures the corneal donor procurement from 2009 to 2015. The rates of corneal donation were examined and analyzed. Among the 5712 hospital deaths, consent for corneal donation was obtained in 711 cases. The mean annual corneal donation rate was 12.4%. Since 2009, the donation rate per year could be increased with exception of 2013 and 2015. In the end of 2012 and 2014 two huge organ donation scandals were known in Germany. In the following years 2013 and 2015 corneal donation rate decreased significantly (P=0.0181 and P=0.0006. We concluded that transplantation scandals have a significant impact on corneal donation rate. Improving professional's performance through full transparency and honesty is very important to earn trust of potential donors and their families.

  2. Organ transplantation scandal influencing corneal donation rate. (United States)

    Röck, Tobias; Bramkamp, Matthias; Bartz-Schmidt, Karl Ulrich; Röck, Daniel


    In the majority of countries, there is a shortage of donor corneas for corneal transplantations. This study investigated the impact of organ transplantation scandals on corneal donation rate at the University Hospital Tübingen. Each deceased patient was considered as a potential corneal donor. An ophthalmic resident handled with stable methods of procedures the corneal donor procurement from 2009 to 2015. The rates of corneal donation were examined and analyzed. Among the 5712 hospital deaths, consent for corneal donation was obtained in 711 cases. The mean annual corneal donation rate was 12.4%. Since 2009, the donation rate per year could be increased with exception of 2013 and 2015. In the end of 2012 and 2014 two huge organ donation scandals were known in Germany. In the following years 2013 and 2015 corneal donation rate decreased significantly ( P =0.0181 and P =0.0006). We concluded that transplantation scandals have a significant impact on corneal donation rate. Improving professional's performance through full transparency and honesty is very important to earn trust of potential donors and their families.

  3. A native-like corneal construct using donor corneal stroma for tissue engineering.

    Directory of Open Access Journals (Sweden)

    Jing Lin

    Full Text Available Tissue engineering holds great promise for corneal transplantation to treat blinding diseases. This study was to explore the use of natural corneal stroma as an optimal substrate to construct a native like corneal equivalent. Human corneal epithelium was cultivated from donor limbal explants on corneal stromal discs prepared by FDA approved Horizon Epikeratome system. The morphology, phenotype, regenerative capacity and transplantation potential were evaluated by hematoxylin eosin and immunofluorescent staining, a wound healing model, and the xeno-transplantation of the corneal constructs to nude mice. An optically transparent and stratified epithelium was rapidly generated on donor corneal stromal substrate and displayed native-like morphology and structure. The cells were polygonal in the basal layer and became flattened in superficial layers. The epithelium displayed a phenotype similar to human corneal epithelium in vivo. The differentiation markers, keratin 3, involucrin and connexin 43, were expressed in full or superficial layers. Interestingly, certain basal cells were immunopositive to antibodies against limbal stem/progenitor cell markers ABCG2 and p63, which are usually negative in corneal epithelium in vivo. It suggests that this bioengineered corneal epithelium shared some characteristics of human limbal epithelium in vivo. This engineered epithelium was able to regenerate in 4 days following from a 4mm-diameter wound created by a filter paper soaked with 1 N NaOH. This corneal construct survived well after xeno-transplantation to the back of a nude mouse. The transplanted epithelium remained multilayer and became thicker with a phenotype similar to human corneal epithelium. Our findings demonstrate that natural corneal stroma is an optimal substrate for tissue bioengineering, and a native-like corneal construct has been created with epithelium containing limbal stem cells. This construct may have great potential for clinical use in

  4. Annular ring zoom system using two positive axicons (United States)

    Dickey, Fred M.; Conner, Jacob D.


    The production of an annular ring of light with a variable diameter has applications in laser material processing and machining, particle manipulation, and corneal surgery. This can readily be accomplished using a positive and negative axicon pair. However, negative axicons are very expensive and difficult to obtain with small diameters. In this paper, we present a design of an annular ring zoom system using two positive axicons. One axicon is placed a distance before a primary lens that is greater than some prescribed minimum, and the second axicon is placed after the primary lens. The position of the second axicon determines the ring diameter. The ring diameter can be zoomed from some maximum design size to a zero diameter ring (spot). Experimental results from a developmental system will be presented.

  5. Can Riboflavin Penetrate Stroma Without Disrupting Integrity of Corneal Epithelium in Rabbits? Iontophoresis and Ultraperformance Liquid Chromatography With Electrospray Ionization Tandem Mass Spectrometry. (United States)

    Novruzlu, Şahin; Türkcü, Ümmühani Özel; Kvrak, İbrahim; Kvrak, Şeyda; Yüksel, Erdem; Deniz, Nuriye Gökçen; Bilgihan, Ayşe; Bilgihan, Kamil


    To examine riboflavin concentrations in corneas and aqueous humor from rabbits with standard and transepithelial methods and iontophoresis without disrupting the integrity of the corneal epithelium before corneal collagen cross-linking. Twenty-four eyes of 12 adult New Zealand rabbits were used. They were assigned to 4 groups, each including 6 eyes. Group 1 was exposed to the standard method and given riboflavin 0.1% after epithelial debridement. Group 2 was exposed to the transepithelial method and given benzalkonium chloride (BAC), ethylenediaminetetraacetic acid (EDTA), trometamol (TRIS), hydroxypropylmethylcellulose (HPMC), and riboflavin 0.2% 3 times at 1.5-minute intervals followed by riboflavin 0.2%. Group 3 was given riboflavin 0.1% by using 1-mA electric current for 10 minutes with the help of iontophoresis without using substances disrupting the integrity of the corneal epithelium. Group 4 received the same treatment as did group 3, except that it was given riboflavin 0.2%. Following these treatments, riboflavin concentrations in aqueous humor and corneas were measured with ultraperformance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (UPLC-ESI-MS/MS). Riboflavin concentrations in the cornea and aqueous humor were higher in group 1 (42.4 ± 5.4 μg/g) than in the other groups. They were significantly higher in group 4 (34.2 ± 6.6 μg/g) than in group 2 (24.4 ± 1.2 μg/g) (P = 0.009) and group 3 (23.6 ± 6.1 μg/g) (P = 0.026). There was not a significant difference in corneal riboflavin concentrations between group 2 and group 3 (P = 0.937). Intrastromal and aqueous riboflavin concentrations after administration of riboflavin 0.2% through iontophoresis without disrupting the integrity of the corneal epithelium were lower than those after the standard method, but higher than those after the transepithelial method. In this study, in which riboflavin concentrations were measured with a very sensitive method

  6. Infliximab eye drops treatment in corneal neovascularization. (United States)

    Voiculescu, O B; Voinea, L M


    Corneal neovascularization is a serious condition that may arise secondary to chemical burns, ischemia, infection, trauma, and inflammation and represents a major cause of blindness. This study investigated the efficacy of topical application of infliximab [tumor necrosis factor-a (TNF-a) monoclonal antibody] in the treatment of corneal neovascularization in the rabbit model.

  7. Corneal Toxicity Associated With Aquarium Coral Palytoxin. (United States)

    Farooq, Asim V; Gibbons, Allister G; Council, Matthew D; Harocopos, George J; Holland, Simon; Judelson, Jeffrey; Shoss, Bradley L; Schmidt, Eric J; Md Noh, Umi Kalthum; D'Angelo, Alexander; Chundury, Rao V; Judelson, Richard; Perez, Victor L; Huang, Andrew J W


    To report a series of patients who developed corneal toxicity after exposure to aquarium coral palytoxin. Multicenter retrospective case series. Retrospective review. Seven patients presented with corneal findings ranging from superficial punctate epitheliopathy to bilateral corneal melt with subsequent perforation. Among those with mild corneal findings, resolution was achieved with topical steroids and lubrication, whereas some patients who developed progressive corneal melt required therapeutic penetrating keratoplasty. The history in all patients revealed exposure to aquarium zoanthid corals shortly before disease onset. A review of the literature revealed that there are few prior reports of coral-associated corneal toxicity and that some species of coral secrete a substance known as palytoxin, a potent vasoconstrictor that inhibits the membranous sodium-potassium ATPase pump across cell types and can cause rapid death if inhaled or ingested. This is the largest case series to date demonstrating patients with aquarium coral palytoxin-associated corneal toxicity, and is the first to provide details of related histopathologic findings. Similar to other forms of toxic keratoconjunctivitis, a detailed history and careful clinical assessment are required, as well as timely removal of the offending agent from the patients' ocular milieu and environment. Mild ocular surface and corneal disease may be treated effectively with aggressive topical steroid therapy and lubrication. Given the potential severity of ocular as well as systemic adverse effects, there should be increased awareness of this entity among eye care professionals, aquarium enthusiasts, and the general public. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Complications from Infective Corneal Conditions Treated by ...

    African Journals Online (AJOL)

    Background: Complications from infective corneal conditions are an important cause of blindness in adults and children. The eyelids play a major role in the pathogenesis of staphyloma and the perforation of descemetoceles. Tarsorrhaphy could, therefore, be beneficial in treating serious complications from infective corneal ...

  9. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    Lapid-Gortzak, Ruth; Nieuwendaal, Carla P.; Slomovic, Allan R.; Spanjaard, Lodewijk


    PURPOSE: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline. METHODS: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of

  10. Corneal laceration caused by river crab

    Directory of Open Access Journals (Sweden)

    Vinuthinee N


    Full Text Available Naidu Vinuthinee,1,2 Anuar Azreen-Redzal,1 Jaafar Juanarita,1 Embong Zunaina2 1Department of Ophthalmology, Hospital Sultanah Bahiyah, Alor Setar, 2Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia Abstract: A 5-year-old boy presented with right eye pain associated with tearing and photophobia of 1-day duration. He gave a history of playing with a river crab when suddenly the crab clamped his fingers. He attempted to fling the crab off, but the crab flew and hit his right eye. Ocular examination revealed a right eye corneal ulcer with clumps of fibrin located beneath the corneal ulcer and 1.6 mm level of hypopyon. At presentation, the Seidel test was negative, with a deep anterior chamber. Culture from the corneal scrapping specimen grew Citrobacter diversus and Proteus vulgaris, and the boy was treated with topical gentamicin and ceftazidime eyedrops. Fibrin clumps beneath the corneal ulcer subsequently dislodged, and revealed a full-thickness corneal laceration wound with a positive Seidel test and shallow anterior chamber. The patient underwent emergency corneal toileting and suturing. Postoperatively, he was treated with oral ciprofloxacin 250 mg 12-hourly for 1 week, topical gentamicin, ceftazidime, and dexamethasone eyedrops for 4 weeks. Right eye vision improved to 6/9 and 6/6 with pinhole at the 2-week follow-up following corneal suture removal. Keywords: corneal ulcer, pediatric trauma, ocular injury


    African Journals Online (AJOL)


    Corneal scraping in corneal ulcerations was done for five children who had not used any medication. These children, with others suspected of having bacterial ulcers that were inadequately treated, were given. *Correspondence: Dr OO Onabolu, Consultant Ophthalmologist, Ophthalmology Department, OACHS, PMB 2027, ...

  12. Serratia corneal ulcers: a retrospective clinical study. (United States)

    Mah-Sadorra, Jeane Haidee; Najjar, Dany M; Rapuano, Christopher J; Laibson, Peter R; Cohen, Elisabeth J


    To study the clinical and microbiological profile of Serratia corneal ulcers at the Cornea Service of the Wills Eye Hospital. This was a retrospective, observational case series. The clinical records of patients with Serratia marcescens corneal ulcers seen at the Cornea Service of the Wills Eye Hospital between January 1, 1998 and December 31, 2002 were reviewed. Twenty-four cases of Serratia keratitis were identified in 21 patients. Two patients (9.5%) had recurrent keratitis, 1 of which recurred twice. Both had corneal graft edema and were on topical steroids and antiglaucoma drops. The Serratia infection in 15 patients (71%) was associated with an abnormal corneal surface. Twelve of these patients (57%) had the ulcer in a corneal graft, 4 (19%) of which were associated with suture infiltrates. Fifteen patients (71%) were on topical medications-15 used corticosteroids and 13 used antiglaucoma drops. Six patients (29%) were contact lens wearers-1 had a concomitant suture infiltrate associated with a corneal graft, and 5 had otherwise healthy corneas. One isolate lacked in vitro susceptibility to ciprofloxacin and ofloxacin but was susceptible to gentamicin and tobramycin. Nineteen patients had a favorable response to medical therapy. Two patients with poor outcome had large corneal ulcers with severe necrosis and thinning associated with delay in treatment. Serratia marcescens keratitis is associated with the presence of an abnormal corneal surface, use of topical medications, and contact lens wear. Prompt medical therapy results in a good clinical response in the majority of cases.

  13. Queratopatía cristalina: diagnóstico clínico y microbiológico de una infección corneal infrecuente causada por el grupo Streptococcus mitis

    Directory of Open Access Journals (Sweden)

    Gustavo J Galperín


    Full Text Available El objetivo del presente informe es describir un caso de queratopatía cristalina causada por microorganismos pertenecientes al grupo Streptococcus mitis en una paciente que concurrió a la consulta oftalmológica por molestias en su ojo derecho. Al examen oftalmológico presentó un punto de sutura interrumpida de nylon 10-0 sin tensión y con secreciones mucosas adheridas. El punto flojo fue retirado bajo normas de asepsia. Se indicó colirio de moxifloxacina al 0,5 %; el ojo tuvo una evolución adecuada, con una correcta epitelización. Sin embargo, luego de 15 días desarrolló un infiltrado blanquecino arboriforme. Se tomó una muestra en el quirófano, enhebrando el trayecto intraestromal de la sutura retirada con sutura de vicryl 7-0. Se indicaron colirios de vancomicina con 50 mg/ml. El infiltrado se mantuvo estable durante 45 días, luego se incrementó el tamaño y se produjo necrosis tisular con peligro de perforación corneal. Se realizó un recubrimiento conjuntival bipediculado. La paciente evolucionó favorablemente y luego de la retracción espontánea del recubrimiento, se observó leucoma cicatrizal y neovasos corneales.Crystalline keratopathy: an infrequent corneal infection produced by the Streptococcus mitis group. The objective of this report is to describe a case of crystalline keratopathy caused by the Streptococcus mitis group corresponding to a patient who attended hospital for discomfort in his right eye. The ophthalmological examination showed an interrupted stitch of 10-0 nylon suture without tension and with attached mucus secretions. The loose suture was removed under aseptic conditions. Moxifloxacin 0.5 % eye drops were topically indicated. The treated eye successfully epithelialized and evolved favorably. However, after 15 days, a white tree-shaped infiltrate developed. A corneal sample was taken in the operating room, threading the intrastromal path of the removed stitch with a 7-0 vicryl suture. Vancomycin 50

  14. Corneal autofluorescence in presence of diabetic retinopathy (United States)

    Rovati, Luigi; Docchio, Franco; Azzolini, Claudio; Van Best, Jaap A.


    Recently corneal autofluorescence has been proposed as an ocular diagnostic tool for diabetic retinopathy. The method is based on the sensible increase of the natural fluorescence of corneal tissue within specific wavelength in presence of early stage of diabetic retinopathy. The main advantages of this method are that the corneal autofluorescence has been demonstrated to be not age-related and that the cornea is readily accessible to be investigated. In this study 47 insulin-dependent diabetes mellitus and 51 non-insulin- dependent diabetes mellitus patients aged 20 - 90 years have been considered. Patients were selected from the Eye Clinic of S. Raffaele Hospital. The modified Airlie House classification was used to grade the diabetic retinopathy. Corneal autofluorescence has been measured by using both a specifically designed instrument and the Fluorotron Master. Corneal autofluorescence mean value for each diabetic retinopathy measured by using both the instruments correlated with the retinopathy grade.

  15. Late onset corneal ectasia after LASIK surgery. (United States)

    Said, Ashraf; Hamade, Issam H; Tabbara, Khalid F


    To report late onset corneal ectasia following myopic LASIK. A retrospective cohort case series. Nineteen patients with late onset corneal ectasia following LASIK procedure were examined at The Eye Center, Riyadh, Saudi Arabia. Patients underwent LASIK for myopia with spherical equivalent ranging from -1.4 to -13.75 diopters. Age and gender, history of systemic or local diseases, and time of onset of corneal ectasia were recorded. Eye examination and corneal topographical analyses were done before and after LASIK surgery. Nineteen patients (29 eyes) with late onset corneal ectasia were identified from 1998 to 2008 in 13 male and six female patients. The mean follow-up period was 108 ± 23 months (range 72-144 months). No patient had pre-operative identifiable risk factors for corneal ectasia and the mean time of onset was 57 ± 24 months (range 24-120 months after LASIK). The pre-operative values included mean central pachymetry 553 ± 25 μm, mean keratometry reading of 42.9 ± 1.5 diopters, average oblique cylinder of 1.4 ± 1.2 diopters, posterior surface elevation of 26 ± 2.1 diopters, corneal flap thickness of 160 μm, mean spherical equivalent of -5.6 ± 3.6 diopters, and calculated residual corneal stromal bed thickness was 288 ± 35 μm. Three (5 eyes) patients developed ectasia after pregnancy. Three (4 eyes) patients developed corneal ectasia following severe adenoviral keratoconjunctivitis and had positive PCR for adenovirus type 8. Corneal ectasia may develop many years after LASIK surgery and symptoms could go undetected for some time. Pregnancy and adenoviral keratoconjunctivitis occurred post-operatively in six patients.

  16. Corneal sensitivity in chronic inflammatory demyelinating polyneuropathy. (United States)

    Bansal, Surbhi; Myneni, Ajay A; Mu, Lina; Myers, Bennett H; Patel, Sangita P


    Neurotrophic keratitis may result from a variety of ocular or systemic diseases. Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune neuropathy that affects any nerve plexus but with no known association with corneal disease. We observed 2 patients with CIDP and visually compromising neurotrophic corneal ulcers. This study was performed to determine the prevalence of neurotrophic corneas in patients with CIDP to identify a subpopulation of asymptomatic patients who are at risk for vision loss. This is an observational case series of 2 patients with CIDP with visually compromising neurotrophic corneal ulcers and a prospective clinical study comparing corneal sensitivity in 9 patients with CIDP versus 9 age- and sex-matched controls. Corneal sensitivity was tested with an esthesiometer. Statistical analyses were performed to determine patterns or significances in relation to the subject's age, gender, and duration and severity of the disease. The overall median corneal sensitivity was 5.7 for patients with CIDP and 6.0 for controls (P = 0.09). The mean corneal sensitivity was 5.6 ± 0.4 in patients with CIDP compared with 5.8 ± 0.3 in controls. No specific pattern was found with age, gender, or duration and severity of the disease among patients with CIDP. Although the case series demonstrated decreased corneal sensitivity in both patients with CIDP, the prospective study detected reduced corneal sensitivity in patients with CIDP when compared with controls, but did not reach statistical significance. Ophthalmic examinations with measurement of corneal sensitivity should be considered in the management of patients with CIDP.Clinical Trial Registration-URL: Unique identifier: NCT01379833.

  17. Construction of a human corneal stromal equivalent with non-transfected human corneal stromal cells and acellular porcine corneal stromata. (United States)

    Diao, Jin-Mei; Pang, Xin; Qiu, Yue; Miao, Ying; Yu, Miao-Miao; Fan, Ting-Jun


    A tissue-engineered human corneal stroma (TE-HCS) has been developed as a promising equivalent to the native corneal stroma for replacement therapy. However, there is still a crucial need to improve the current approaches to render the TE-HCS equivalent more favorable for clinical applications. At the present study, we constructed a TE-HCS by incubating non-transfected human corneal stromal (HCS) cells in an acellular porcine corneal stromata (aPCS) scaffold in 20% fetal bovine serum supplemented DMEM/F12 (1:1) medium at 37 °C with 5% CO2in vitro. After 3 days of incubation, the constructed TE-HCS had a suitable tensile strength for transplantation, and a transparency that is comparable to native cornea. The TE-HCS had a normal histological structure which contained regularly aligned collagen fibers and differentiated HCS cells with positive expression of marker and functional proteins, mimicking a native HCS. After transplantation into rabbit models, the TE-HCS reconstructed normal corneal stroma in vivo and function well in maintaining corneal clarity and thickness, indicating that the completely biological TE-HCS could be used as a HCS equivalent. The constructed TE-HCS has promising potentials in regenerative medicine and treatment of diseases caused by corneal stromal disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Intraoperative corneal thickness measurements during corneal collagen cross-linking with isotonic riboflavin solution without dextran in corneal ectasia. (United States)

    Cınar, Yasin; Cingü, Abdullah Kürşat; Sahin, Alparslan; Türkcü, Fatih Mehmet; Yüksel, Harun; Caca, Ihsan


    Abstract Objective: To monitor the changes in corneal thickness during the corneal collagen cross-linking procedure by using isotonic riboflavin solution without dextran in ectatic corneal diseases. The corneal thickness measurements were obtained before epithelial removal, after epithelial removal, following the instillation of isotonic riboflavin solution without dextran for 30 min, and after 10 min of ultraviolet A irradiation. Eleven eyes of eleven patients with progressive keratoconus (n = 10) and iatrogenic corneal ectasia (n = 1) were included in this study. The mean thinnest pachymetric measurements were 391.82 ± 30.34 µm (320-434 µm) after de-epithelialization of the cornea, 435 ± 21.17 µm (402-472 µm) following 30 min instillation of isotonic riboflavin solution without dextran and 431.73 ± 20.64 µm (387-461 µm) following 10 min of ultraviolet A irradiation to the cornea. Performing corneal cross-linking procedure with isotonic riboflavin solution without dextran might not induce corneal thinning but a little swelling throughout the procedure.

  19. Corneal Regeneration by Deep Anterior Lamellar Keratoplasty (DALK Using Decellularized Corneal Matrix.

    Directory of Open Access Journals (Sweden)

    Yoshihide Hashimoto

    Full Text Available The purpose of this study is to demonstrate the feasibility of DALK using a decellularized corneal matrix obtained by HHP methodology. Porcine corneas were hydrostatically pressurized at 980 MPa at 10°C for 10 minutes to destroy the cells, followed by washing with EGM-2 medium to remove the cell debris. The HHP-treated corneas were stained with H-E to assess the efficacy of decellularization. The decellularized corneal matrix of 300 μm thickness and 6.0 mm diameter was transplanted onto a 6.0 mm diameter keratectomy wound. The time course of regeneration on the decellularized corneal matrix was evaluated by haze grading score, fluorescein staining, and immunohistochemistry. H-E staining revealed that no cell nuclei were observed in the decellularized corneal matrix. The decellularized corneal matrices were opaque immediately after transplantation, but became completely transparent after 4 months. Fluorescein staining revealed that initial migration of epithelial cells over the grafts was slow, taking 3 months to completely cover the implant. Histological sections revealed that the implanted decellularized corneal matrix was completely integrated with the receptive rabbit cornea, and keratocytes infiltrated into the decellularized corneal matrix 6 months after transplantation. No inflammatory cells such as macrophages, or neovascularization, were observed during the implantation period. The decellularized corneal matrix improved corneal transparency, and remodelled the graft after being transplanted, demonstrating that the matrix obtained by HHP was a useful graft for corneal tissue regeneration.

  20. The impact of type 1 diabetes mellitus on corneal epithelial nerve morphology and the corneal epithelium. (United States)

    Cai, Daniel; Zhu, Meifang; Petroll, W Matthew; Koppaka, Vindhya; Robertson, Danielle M


    Diabetic corneal neuropathy can result in chronic, sight-threatening corneal pathology. Although the exact etiology is unknown, it is believed that a reduction in corneal sensitivity and loss of neurotrophic support contributes to corneal disease. Information regarding the relationship between nerve loss and effects on the corneal epithelium is limited. We investigated changes in the corneal epithelium and nerve morphology using three-dimensional imaging in vivo and in situ in a streptozotocin-induced diabetic mouse model. Streptozotocin-treated mice showed increased levels of serum glucose and growth retardation consistent with a severe diabetic state. A reduction in the length of the subbasal nerve plexus was evident after 6 weeks of disease. Loss of the subbasal nerve plexus was associated with corneal epithelial thinning and a reduction in basal epithelial cell density. In contrast, loss of the terminal epithelial nerves was associated with animal age. Importantly, this is the first rodent model of type 1 diabetes that shows characteristics of corneal epithelial thinning and a reduction in basal epithelial cell density, both previously have been documented in humans with diabetic corneal neuropathy. These findings indicate that in type 1 diabetes, nerve fiber damage is evident in the subbasal nerve plexus before terminal epithelial nerve loss and that neurotrophic support from both the subbasal nerve plexus and terminal epithelial nerves is essential for the maintenance of corneal epithelial homeostasis. Copyright © 2014 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  1. High interocular corneal symmetry in average simulated keratometry, central corneal thickness, and posterior elevation. (United States)

    Myrowitz, Elliott H; Kouzis, Anthony C; O'Brien, Terrence P


    The purpose of this study was to assess interocular corneal symmetry in average simulated keratometry, corneal thickness, and posterior corneal elevation. This retrospective analysis included data from scanning slit topography (Orbscan II; Bausch and Lomb, Rochester, NY) on 242 eyes from 121 consecutive patients undergoing standard evaluation for consideration of elective laser vision correction. The symmetry between the right and left eye in average simulated keratometry, minimum central corneal thickness, and posterior corneal elevation was assessed by comparative data analysis. Simulated keratometry ranged from 39.9 to 48.6 D. The interocular difference in average simulated keratometry was 0.47 D (standard deviation [SD] 0.43). The interocular Pearson correlation coefficient for average simulated keratometry was 0.90 (p central corneal thickness was 0.95 (p symmetry in all these parameters was very high in this group of consecutive patients. Asymmetry of these interocular parameters may warrant repeat clinical testing for accuracy and may predict corneal abnormalities. Normative data on posterior cornea elevation is presented. This study points out potentially clinically important high interocular corneal symmetry data in simulated keratometry, corneal thickness, and posterior corneal elevation.

  2. Corneal modeling for analysis of photorefractive keratectomy (United States)

    Della Vecchia, Michael A.; Lamkin-Kennard, Kathleen


    Procedurally, excimer photorefractive keratectomy is based on the refractive correction of composite spherical and cylindrical ophthalmic errors of the entire eye. These refractive errors are inputted for correction at the corneal plane and for the properly controlled duration and location of laser energy. Topography is usually taken to correspondingly monitor spherical and cylindrical corneorefractive errors. While a corneal topographer provides surface morphologic information, the keratorefractive photoablation is based on the patient's spherical and cylindrical spectacle correction. Topography is at present not directly part of the procedural deterministic parameters. Examination of how corneal curvature at each of the keratometric reference loci affect the shape of the resultant corneal photoablated surface may enhance the accuracy of the desired correction. The objective of this study was to develop a methodology to utilize corneal topography for construction of models depicting pre- and post-operative keratomorphology for analysis of photorefractive keratectomy. Multiple types of models were developed then recreated in optical design software for examination of focal lengths and other optical characteristics. The corneal models were developed using data extracted from the TMS I corneal modeling system (Computed Anatomy, New York, NY). The TMS I does not allow for manipulation of data or differentiation of pre- and post-operative surfaces within its platform, thus models needed to be created for analysis. The data were imported into Matlab where 3D models, surface meshes, and contour plots were created. The data used to generate the models were pre- and post-operative curvatures, heights from the corneal apes, and x-y positions at 6400 locations on the corneal surface. Outlying non-contributory points were eliminated through statistical operations. Pre- and post- operative models were analyzed to obtain the resultant changes in the corneal surfaces during PRK

  3. Terahertz sensing in corneal tissues (United States)

    Bennett, David B.; Taylor, Zachary D.; Tewari, Pria; Singh, Rahul S.; Culjat, Martin O.; Grundfest, Warren S.; Sassoon, Daniel J.; Johnson, R. Duncan; Hubschman, Jean-Pierre; Brown, Elliott R.


    This work introduces the potential application of terahertz (THz) sensing to the field of ophthalmology, where it is uniquely suited due to its nonionizing photon energy and high sensitivity to water content. Reflective THz imaging and spectrometry data are reported on ex-vivo porcine corneas prepared with uniform water concentrations using polyethylene glycol (PEG) solutions. At 79% water concentration by mass, the measured reflectivity of the cornea was 20.4%, 14.7%, 11.7%, 9.6%, and 7.4% at 0.2, 0.4, 0.6, 0.8, and 1 THz, respectively. Comparison of nine corneas hydrated from 79.1% to 91.5% concentration by mass demonstrated an approximately linear relationship between THz reflectivity and water concentration, with a monotonically decreasing slope as the frequency increases. The THz-corneal tissue interaction is simulated with a Bruggeman model with excellent agreement. THz applications to corneal dystrophy, graft rejection, and refractive surgery are examined from the context of these measurements. PMID:21639581

  4. Contact Lens Visual Rehabilitation in Keratoconus and Corneal Keratoplasty

    Directory of Open Access Journals (Sweden)

    Yelda Ozkurt


    Full Text Available Keratoconus is the most common corneal distrophy. It’s a noninflammatory progressive thinning process that leads to conical ectasia of the cornea, causing high myopia and astigmatism. Many treatment choices include spectacle correction and contact lens wear, collagen cross linking, intracorneal ring segments implantation and finally keratoplasty. Contact lenses are commonly used to reduce astigmatism and increase vision. There are various types of lenses are available. We reviewed soft contact lenses, rigid gas permeable contact lenses, piggyback contact lenses, hybrid contact lenses and scleral-semiscleral contact lenses in keratoconus management. The surgical option is keratoplasty, but even after sutur removal, high astigmatism may stil exists. Therefore, contact lens is an adequate treatment option to correct astigmatism after keratoplasty.

  5. [Influence of corneal transparency on the quality of topographies]. (United States)

    Franko Zeitz, P; Kohlhaas, M


    Corneal topographs that measure the anterior and posterior corneal surface with optical methods need a clear cornea for precise measurements. Opacities cause artifacts in the corneal thickness (with measurements usually being too thin) and corneal curvatures. This is important to know as certain pathologies may repeatedly cause similar artifacts. This is highly relevant after a corneal cross-linking, Lasek or PRK, as these procedures cause typical artifacts that can easily be misinterpreted. Georg Thieme Verlag KG Stuttgart · New York.

  6. A thermoreversible hydrogel as a biosynthetic bandage for corneal wound repair. (United States)

    Pratoomsoot, Chayanin; Tanioka, Hidetoshi; Hori, Kuniko; Kawasaki, Satoshi; Kinoshita, Shigeru; Tighe, Patrick J; Dua, Harminder; Shakesheff, Kevin M; Rose, Felicity Rosamari A J


    Ocular trauma and disorders that lead to corneal blindness account for over 2 million new cases of monocular blindness every year. A popular ocular surface reconstruction therapy, amniotic membrane transplantation, has been shown to aid corneal wound repair. However, the success rates of the procedure are variable. Here, we proposed to bioengineer a novel synthetic material that would serve as a biomimetic corneal bandage. The PLGA-PEG-PLGA triblock copolymer was synthesised via ring-opening polymerisation. Thermoreversible gelation behaviour was investigated at different polymer concentrations (23%, 30%, 35%, 40%, 45%, w/v) at temperatures ranging between 5 and 60 degrees C. Viscoelastic properties were studied in dynamic mechanical analysis with 1 degrees C/min temperature ramp. Cryo-SEM revealed a porous hydrogel with interconnecting networks. No adverse cytotoxicity was observed with an in vitro scratch-wound assay and in in vivo biocompatibility tests. We have demonstrated that the PLGA-PEG-PLGA hydrogel possessed a suitable gelling profile and, for the first time, the biocompatibility properties for this application as a potential bandage for corneal wound repair.

  7. Corneal endothelial dysfunction in Pearson syndrome. (United States)

    Kasbekar, Shivani A; Gonzalez-Martin, Jose A; Shafiq, Ayad E; Chandna, Arvind; Willoughby, Colin E


    Mitochondrial disorders are associated with well recognized ocular manifestations. Pearson syndrome is an often fatal, multisystem, mitochondrial disorder that causes variable bone marrow, hepatic, renal and pancreatic exocrine dysfunction. Phenotypic progression of ocular disease in a 12-year-old male with Pearson syndrome is described. This case illustrates phenotypic drift from Pearson syndrome to Kearns-Sayre syndrome given the patient's longevity. Persistent corneal endothelial failure was noted in addition to ptosis, chronic external ophthalmoplegia and mid-peripheral pigmentary retinopathy. We propose that corneal edema resulting from corneal endothelial metabolic pump failure occurs within a spectrum of mitochondrial disorders.

  8. Should nylon corneal sutures be routinely removed? (United States)

    Jackson, H.; Bosanquet, R.


    Three groups of patients who had undergone cataract extraction through a corneal incision closed with 10/0 nylon sutures one, two, and three years previously were recalled to determine the incidence of suture related complications. Broken corneal sutures were found in 87.5% of patients after two years and 90% after three years and were causing symptoms in over half the patients. It is recommended that 10/0 nylon corneal sutures be routinely removed no later than one year after surgery. Images PMID:1751460

  9. Corneal dermoid in two laboratory beagle dogs. (United States)

    Horikiri, K; Ozaki, K; Maeda, H; Narama, I


    Two male laboratory beagle dogs used in toxicity studies, one 7 months old and the other 9 months old, showed the evidence of corneal dermoid. Grossly, the dermoid was observed in both cases as hair growth from the cornea. In one case, the hairs had been removed from the cornea, but regrowth was observed about 70 days later. Histopathologically, melanocytes, melanin granules, hairs, hair bulbs, adipose tissue and sebaceous and sweat glands were observed in the corneal epithelium and propria. According to the information obtained from 4 breeders, the incidence of corneal dermoid was extremely rare in laboratory beagle dogs.

  10. Correlation of both corneal surfaces in corneal ectasia after myopic LASIK. (United States)

    Peinado, Teresa Fernández; Piñero, David P; López, Ignacio Alcaraz; Alio, Jorge L


    We report a case of corneal ectasia in a 25-year-old man after myopic laser in situ keratomileusis in which a complete characterization of the corneal structure was performed by means of a Scheimpflug photography-based system. The patient presented in the ectatic eye with a subjective refraction of +0.50 to 6.00 × 100°, which with correction gave a visual acuity of 20/25. With the topographic analysis, corneal shapes from both corneal surfaces at the four different quadrants were found to be complementary, maintaining the meniscus-shaped profile of the cornea. This correlation between the anterior and posterior corneal surfaces was also confirmed with an optical tomography evaluation. Corneal biomechanics was also evaluated by means of the Ocular Response Analyzer (Reichert), which confirmed the biomechanical alteration. In summary, biomechanical changes leading to corneal ectasia in this case affected the global corneal structure, inducing alterations in the shape of both anterior and posterior corneal surfaces.

  11. Repair of corneal ulcer or perforation using the corneal stromal lenticule

    Directory of Open Access Journals (Sweden)

    Xiao-Feng Hao


    Full Text Available AIM: To describe the outcomes of corneal stromal lenticules in repairing of corneal ulcer and/or perforation. METHODS: This was a retrospective chart review of 6 eyes of 6 patients from January to June 2017,who underwent corneal ulcer repair with the corneal, stromal lenticules harvested from femtosecond laser refractive surgery and kept in pure glycerin for use. Three cases of infectious corneal ulcers were bacterial, fungal, and infection with foreign bodies in corneal deep layer, one each. The other 3 were corneal ulcer perforation. Making sure no air bubble between donor graft and Descemet membrane. The mean follow-up time was 3.71±1.56mo(range 1-6mo. RESULTS: All eyes were successfully treated under control of infection without intra-operative complications, and early postoperative evaluation showed a clear graft in all cases. The last follow-up visit showed the mean best corrected visual acuity(VAsignificantly improved after surgery. There was significant difference from 0.48±0.12 to 1.50±0.08(PCONCLUSION: The preliminary results suggest that the use of corneal stromal lenticules may be a safe and effective surgical alternative for corneal ulcer, even though the long-term outcome of the graft needs to be further observed.

  12. Ringing phenomenon of the fiber ring resonator. (United States)

    Ying, Diqing; Ma, Huilian; Jin, Zhonghe


    A resonator fiber-optic gyro (R-FOG) is a high-accuracy inertial rotation sensor based on the Sagnac effect. A fiber ring resonator is the core sensing element in the R-FOG. When the frequency of the fiber ring resonator input laser is swept linearly with time, ringing of the output resonance curve is observed. The output field of the fiber ring resonator is derived from the superposition of the light transmitted through the directional coupler directly and the multiple light components circulated in the fiber ring resonator when the frequency of the laser is swept. The amplitude and phase of the output field are analyzed, and it is found that the difference in time for different light components in the fiber ring resonator to reach a point of destructive interference causes the ringing phenomenon. Finally the ringing phenomenon is observed in experiments, and the experimental results agree with the theoretical analysis well.

  13. Genetics Home Reference: congenital stromal corneal dystrophy (United States)

    ... the cornea appears cloudy and may have an irregular surface. These corneal changes lead to visual impairment, ... IGF I) epitopes recognized by monoclonal and polyclonal antibodies to IGF I. Endocrinology. 1990 Jun;126(6): ...

  14. Conjunctival intraepithelial neoplasia with corneal furrow degeneration

    Directory of Open Access Journals (Sweden)

    Pukhraj Rishi


    Full Text Available A 68-year-old man presented with redness of left eye since six months. Examination revealed bilateral corneal furrow degeneration. Left eye lesion was suggestive of conjunctival squamous cell carcinoma, encroaching on to cornea. Anterior segment optical coherence tomography (AS-OCT confirmed peripheral corneal thinning. Fluorescein angiography confirmed intrinsic vascularity of lesion. Patient was managed with "no touch" surgical excision, dry keratectomy without alcohol, cryotherapy, and primary closure. Pathologic examination of removed tissue confirmed clinical diagnosis. Management of this particular case required modification of standard treatment protocol. Unlike the alcohol-assisted technique of tumor dissection described, ethyl alcohol was not used for risk of corneal perforation due to underlying peripheral corneal thinning. Likewise, topical steroids were withheld in the post-operative period. Three weeks post-operatively, left eye was healing well. Hence, per-operative usage of absolute alcohol and post-operative use of topical steroids may be best avoided in such eyes.


    Directory of Open Access Journals (Sweden)

    M. B. Smirnov


    Full Text Available The paper has proved that an associative ring which is solvable of a n- class as a Lie ring has a nilpotent ideal of the nilpotent class not more than 3×10n–2  and a corresponding quotient ring satisfies an identity [[x1, x2, [x3, x4

  16. [Nanostructured bioplastic material for traumatic corneal injuries]. (United States)

    Kanyukov, V N; Stadnikov, A A; Trubina, O M; Yakhina, O M


    To substantiate the use of nanostructured bioplastic material for the treatment of traumatic eye injuries. The study enrolled 96 eyes of 48 rabbits and was carried out in 3 series of experiments, different in the type of induced corneal trauma: mechanical erosion, alkaline or acid burn. The animals were clinically monitored and sacrificed for morphological investigation at days 3, 7, 14, 30, and 90. The size of mechanical corneal erosions was repeatedly evaluated with fluorescein eye stain test. In the experimental group, Hyamatrix biomaterial was topically administered according to an original technique. In the controls, soft contact lenses were inserted and sutured. Complete closure of the epithelial defect with no impact on corneal properties was achieved in 3 days in the experimental group and in4 days in the control group. As for alkaline and acid corneal burns, experimental and control groups received Hyamatrix biomaterial and Solcoseryl eye gel correspondingly. In the experimental group of alkaline burn the defect closed by day 7, in the controls--by day 10-11. Acid-induced corneal edema also resolved by day 7 in the experimental group and by day 14 in the control group. 1. The results of this experimental and morphological study prove the hyaluronic acid-derived nanostructured bioplastic material effective in accelerating corneal re-epithelialization after mechanical erosions as compared with the controls. 2. Topical application of the hyaluronic acid-derived nanostructured bioplastic material shortens the exudative phase of inflammation, promotes corneal defect closure with formation of a more subtle opacification, and stimulates corneal restoration after chemical burns.

  17. Risk factors for corneal ectasia after LASIK. (United States)

    Tabbara, Khalid F; Kotb, Amgad A


    To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.

  18. Corneal elastosis within lattice dystrophy lesions. (United States)

    Pe'er, J; Fine, B S; Dixon, A; Rothberg, D S


    Corneal buttons of two patients with lattice corneal dystrophy were studied by light and electron microscopy. They showed elastotic degeneration within the amyloid deposits. The amyloid deposits displayed characteristic staining; the elastotic material (elastin) within the deposits stained positive with Verhoeff-van Gieson and Movat pentachrome stains and showed autofluorescence. The characteristic ultrastructural findings of amyloid and elastotic material were also demonstrated. The possibility of the associations of these two materials in the cornea is discussed. Images PMID:3258531

  19. Effects of axial length and corneal curvature on corneal biomechanics in elderly population

    Directory of Open Access Journals (Sweden)

    Sha-Sha Song


    Full Text Available AIM:To explore the corneal biomechanical properties of the elderly with different axial length(ALand corneal curvature by corneal visualization Scheimpflug Technology(Corvis ST. METHODS: Cross-sectional study. A total of 161 patients(297 eyesundergoing phacoemulsification were collected in this study. They were divided into 22-24mm, 24-26mm, more than 26mm groups according to axial length(190 eyes, 54 eyes and 53 eyes, respectively. Those of whom axial length was 22-24mm and the corneal curvature was 42-44D were divided into male and female groups(44 eyes and 49 eyes, respectively. Those of whom axial length was 22-24mm were divided into 42-44D group, more than 44D group according to corneal curvature(88 eyes, 102 eyes, respectively. Corvis ST was used to measure the biomechanical parameters of the cornea. The differences in the parameters between different groups were analyzed using the independent-samples t test or one-way analysis of variance and correlation analyses were performed using Pearson correlation analysis. RESULTS: When comparing the corneal biomechanical parameters, no statistically significant differences were found between male and female groups(P>0.05. The first applanation length and second applanation length among different corneal curvatures were statistically significant(PPr=0.429, 0.278; Pr=-0.291, -0.415; PCONCLUSION: The corneal curvature and ocular axial length may be the factors affecting the corneal biomechanical characteristics. The longer axial length, the thinner corneal thickness, the more easily the corneal is deformed, and with the increase of the axial length, intraocular pressure also increases.

  20. Radical theory of rings

    CERN Document Server

    Gardner, JW


    Radical Theory of Rings distills the most noteworthy present-day theoretical topics, gives a unified account of the classical structure theorems for rings, and deepens understanding of key aspects of ring theory via ring and radical constructions. Assimilating radical theory's evolution in the decades since the last major work on rings and radicals was published, the authors deal with some distinctive features of the radical theory of nonassociative rings, associative rings with involution, and near-rings. Written in clear algebraic terms by globally acknowledged authorities, the presentation

  1. Corneal crystals: a precursor to cancer. (United States)

    Chou, Janel L; Sink, Makesha L


    Corneal crystalline deposits are a sign of a limited number of conditions that can often be differentiated based on the appearance and pattern of the deposits. Although, there are limited treatment options available to reduce the appearance or effects of corneal crystals, it is important to identify the correct etiology of these deposits. There are several associated systemic conditions, some of which are life threatening, for which treatments are available. A 51-year-old black male presented to the clinic with the complaint of "glare at night due to crystals on [the] cornea." Slitlamp findings revealed diffuse subepithelial and anterior stromal crystals across both corneas. The patient had a medical history of renal insufficiency and arthralgia. Through systemic testing, the patient was found to have monoclonal gammopathy of undetermined significance (MGUS), and subsequent follow-up of this patient revealed a conversion of MGUS to multiple myeloma. Corneal crystals can appear diffusely through the cornea secondary to corneal dystrophies, gammopathies, cystinosis, or other rare systemic conditions. In this case report, these crystals are secondary to MGUS, which progressed to multiple myeloma. These crystals consist of immunoglobulin, primarily IgG, and excessive kappa light chains. It is important to obtain laboratory tests and make appropriate referrals to determine whether corneal crystal deposits are associated with a serious systemic disease or merely a corneal dystrophy.

  2. Iteratively re-weighted bi-cubic spline representation of corneal topography and its comparison to the standard methods. (United States)

    Zhu, Zhongxia; Janunts, Edgar; Eppig, Timo; Sauer, Tomas; Langenbucher, Achim


    The aim of this study is to represent the corneal anterior surface by utilizing radius and height data extracted from a TMS-2N topographic system with three different mathematical approaches and to simulate the visual performance. An iteratively re-weighted bi-cubic spline method is introduced for the local representation of the corneal surface. For comparison, two standard mathematical global representation approaches are used: the general quadratic function and the higher order Taylor polynomial approach. First, these methods were applied in simulations using three corneal models. Then, two real eye examples were investigated: one eye with regular astigmatism, and one eye which had undergone refractive surgery. A ray-tracing program was developed to evaluate the imaging performance of these examples with each surface representation strategy at the best focus plane. A 6 mm pupil size was chosen for the simulation. The fitting error (deviation) of the presented methods was compared. It was found that the accuracy of the topography representation was worst using the quadratic function and best with bicubic spline. The quadratic function cannot precisely describe the irregular corneal shape. In order to achieve a sub-micron fitting precision, the Taylor polynomial's order selection behaves adaptive to the corneal shape. The bi-cubic spline shows more stable performance. Considering the visual performance, the more precise the cornea representation is, the worse the visual performance is. The re-weighted bi-cubic spline method is a reasonable and stable method for representing the anterior corneal surface in measurements using a Placido-ring-pattern-based corneal topographer. Copyright © 2010. Published by Elsevier GmbH.

  3. Corneal blindness and current major treatment concern-graft scarcity

    Directory of Open Access Journals (Sweden)

    Kah Hie Wong


    Full Text Available According to World Health Organization, the global prevalence of blindness in 2010 was 39 million people, among which 4% were due to corneal opacities. Often, the sole resort for visual restoration of patients with damaged corneas is corneal transplantation. However, despite rapid developments of surgical techniques, instrumentations and immunosuppressive agents, corneal blindness remains a prevalent global health issue. This is largely due to the scarcity of good quality corneal grafts. In this review, the causes of corneal blindness, its major treatment options, and the major contributory factors of corneal graft scarcity with potential solutions are discussed.

  4. Penetrating keratoplasty for perforated corneal ulcers: preservation of iris by corneal debulking. (United States)

    Vajpayee, Rasik B; Singhvi, Arun; Sharma, Namrata; Sinha, Rajesh


    This study was designed to study an alternative technique of lamellar separation of corneal layers for therapeutic keratoplasty in place of an en bloc removal of host corneal button in eyes with perforated corneal ulcers with pseudocornea. Twelve eyes with perforated corneal ulcers with pseudocornea in which therapeutic keratoplasty was planned were included in the study. A new technique was used in which the host corneal tissue was removed in layers by lamellar dissection started peripherally and proceeding centripetally with care taken to prevent perforation at the site of iris incarceration. After injection of viscoelastic into the anterior chamber with a 26-gauge needle entered tangentially, the deeper layer of the cornea was then gently dissected and peeled away from the iris tissue, with care not to avulse the fragile iris and the overlying fibrotic membrane. Adjunctive procedures were performed, and the donor tissue was secured over the host bed. A complete separation of the iris tissue from corneal button and the fibrous membrane was achieved in 9 eyes. In 3 eyes, iris was partly trimmed along with the fibrous membrane, because the membrane was totally adherent to the iris tissue. Eight patients required pupilloplasty. Apart from minimal bleeding, no other complication was encountered. At the end of 3 months, 9 of 12 grafts remained clear. Debulking and layer-by-layer removal of host corneal tissue is effective in preservation of iris while performing therapeutic keratoplasty in eyes with perforated corneal ulcers with pseudocornea.

  5. Stirling engine piston ring (United States)

    Howarth, Roy B.


    A piston ring design for a Stirling engine wherein the contact pressure between the piston and the cylinder is maintained at a uniform level, independent of engine conditions through a balancing of the pressure exerted upon the ring's surface and thereby allowing the contact pressure on the ring to be predetermined through the use of a preloaded expander ring.

  6. [Corneal protection in contact lens users]. (United States)

    Egorova, G B; Mitichkina, T S; Shamsudinova, A R


    To evaluate the efficacy of corneoprotective agents (Corneregel and Solcoseryl) in contact lens users. A total of 66 long-term contact lens wearers with dry eye symptoms and varying degrees of corneal epitheliopathy were monitored. All patients used artificial tears, which, however, were not effective enough to suppress manifestations of corneal epitheliopathy and to release the associated discomfort. The therapy was supplemented with Corneregel. The following examination methods were applied: biomicroscopy with fluorescent staining, Norn test, Schirmer's test, advanced tearscopy with digital image analysis of the precorneal tear film lipid layer, corneal confocal microscopy. In all cases the assessment was performed prior to starting Corneregel and repeated in 7 days, 14 days and 1 month. Complete corneal re-epithelization and restoration of the most superficial layer of the epithelium were achieved within 7-14 days. In case of severe initial epitheliopathy the effect of Corneregel was not sufficient and epithelium defects remained. These patients additionally received Solcoseryl Eye Gel. After the treatment course the condition of corneal epithelium ameliorated and contact lens wearing comfort increased. A longer precorneal tear film break-up time indicated an increase of tear film stability. The total tear production did not change significantly. The moistening effect of Corneregel and low-viscosity artificial tears together with intensive regeneration of corneal epithelium enables structural recovery of the epithelial membrane and considerable improvement of the anterior corneal stroma. At the first stage of corneoprotective treatment it is appropriate to use preservative-free artificial tears of low and high viscosity. If the effect of tear substitutive therapy is unsatisfactory it is recommended to prescribe Corneregel and Solcoseryl. The regimen is to be adjusted individually.

  7. Alternative loop rings

    CERN Document Server

    Goodaire, EG; Polcino Milies, C


    For the past ten years, alternative loop rings have intrigued mathematicians from a wide cross-section of modern algebra. As a consequence, the theory of alternative loop rings has grown tremendously. One of the main developments is the complete characterization of loops which have an alternative but not associative, loop ring. Furthermore, there is a very close relationship between the algebraic structures of loop rings and of group rings over 2-groups. Another major topic of research is the study of the unit loop of the integral loop ring. Here the interaction between loop rings and group ri

  8. Riboflavin for corneal cross-linking. (United States)

    O'Brart, D P S


    Corneal collagen cross-linking (CXL) with riboflavin and ultraviolet A (UVA) radiation is the first therapeutic modality that appears to arrest the progression of keratoconus and other corneal ectasias. Riboflavin is central to the process, acting as a photosensitizer for the production of oxygen singlets and riboflavin triplets. These free radicals drive the CXL process within the proteins of the corneal stroma, altering its biomechanical properties. Riboflavin also absorbs the majority of the UVA radiation, which is potentially cytotoxic and mutagenic, within the anterior stroma, preventing damage to internal ocular structures, such as the corneal endothelium, lens and retina. Clinical studies report cessation of ectatic progression in over 90% of cases and the majority document significant improvements in visual, keratometric and topographic parameters. Clinical follow-up is limited to 5-10 years, but suggests sustained stability and enhancement in corneal shape. Sight-threatening complications are rare. The optimal stromal riboflavin dosage for CXL is as yet undetermined. Copyright 2016 Prous Science, S.A.U. or its licensors. All rights reserved.

  9. MicroRNA-184 Regulates Corneal Lymphangiogenesis. (United States)

    Grimaldo, Sammy; Yuen, Don; Theis, Jaci; Ng, Melissa; Ecoiffier, Tatiana; Chen, Lu


    MicroRNAs are a class of small noncoding RNAs that negatively regulate gene expression by binding to complimentary sequences of target messenger RNA. Their roles in corneal lymphangiogenesis are largely unknown. This study was to investigate the specific role of microRNA-184 (mir-184) in corneal lymphangiogenesis (LG) in vivo and lymphatic endothelial cells (LECs) in vitro. Standard murine suture placement model was used to study the expressional change of mir-184 in corneal inflammatory LG and the effect of synthetic mir-184 mimic on this process. Additionally, a human LEC culture system was used to assess the effect of mir-184 overexpression on cell functions in vitro. Expression of mir-184 was significantly downregulated in corneal LG and, accordingly, its synthetic mimic suppressed corneal lymphatic growth in vivo. Furthermore, mir-184 overexpression in LECs inhibited their functions of adhesion, migration, and tube formation in vitro. These novel findings indicate that mir-184 is involved critically in LG and potentially could be used as an inhibitor of the process. Further investigation holds the promise for divulging new therapies for LG disorders, which occur inside and outside the eye.

  10. Corneal reconstruction by stem cells and bioengineering

    Directory of Open Access Journals (Sweden)

    Arjamaa O


    Full Text Available Olli ArjamaaDepartment of Biology, University of Turku, Turku, FinlandAbstract: Almost 300 million people are visually impaired worldwide due to various eye diseases such as cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, and corneal diseases. Notably, ten million people are blind because of severe ocular surface diseases and the majority of cases occur in developing countries. Blinding ocular surface diseases have, however, become treatable by grafting of surface layers, or by full-thickness transplantation of the cornea. As the demand for human corneal tissue for surface reconstruction and transplantation far exceeds the supply, methods are being developed to supplement tissue donation. Xenotransplantation of the cornea or cells from genetically modified pigs may become one of the solutions. Transplantation of limbal stem cells within tissue biopsies, to restore the transparency of the cornea is another remarkable method, which has shown its potential in several clinical studies. The combination of stem cell technology and engineering of biocompatible tissue equivalent, still at preclinical stage, has shown us how synthetic corneal tissue is able to guide cultured corneal stromal stem cells of human origin, to become native-like stroma, the most important layer of the cornea. These findings give hope for a large-quantity production of biomaterial for corneal reconstruction. As such, clinical ophthalmologists should become more familiar with the methods of laboratory science.Keywords: eye, grafting, keratoplasty, xenotransplantation, cell reservoir, biocompatible tissue equivalent

  11. Primary central corneal hemangiosarcoma in a dog. (United States)

    Haeussler, David J; Rodríguez, Laura Muñoz; Wilkie, David A; Premanandan, Chris


    To report a case of primary central corneal hemangiosarcoma in the dog. An 11-year-old, neutered, female, German shepherd mixed breed dog was referred to the Hospital Veterinario Sierra de Madrid (Spain) for evaluation of an enlarging corneal mass of the left eye (OS). The dog was predominantly housed outdoors and was diagnosed with a history of chronic superficial keratitis of both eyes (OU) by the referring veterinarian. The corneal mass was resected by routine superficial keratectomy and submitted for histopathology and Factor VIII immunohistochemical staining. The mass was diagnosed as a corneal hemangiosarcoma with complete excision. Postoperatively, the keratectomy site healed without complication and there was no evidence of recurrence three and a half months postoperatively. Complete systemic evaluation, including abdominal ultrasound and CT scan of the head and thorax, indicated no other detectable neoplasia in the dog. Outdoor housing and ultraviolet exposure, breed, and chronic superficial keratitis were all suspected as contributing factors to the development of a primary corneal hemangiosarcoma. Surgical removal and postoperative treatment for chronic superficial keratitis provided effective therapy. © 2011 American College of Veterinary Ophthalmologists.

  12. Real Closed Rings and Real Closed * Rings


    Capco, Jose


    Here we try to distinguish and compare different notions of real closedness mainly one developed by N. Schwartz in his Habilitationschrift and the other developed by A. Sankaranand K. Varadarajan which we shall call real closed *. We stick to the definition of real closed rings as defined and characterized N. Schwartz and we try to determine and characterize real closed rings that are real closed *. The main result is that real closed rings have unique real closure * and that real closure of ...

  13. Bilateral coexistence of keratoconus and macular corneal dystrophy

    Directory of Open Access Journals (Sweden)

    Ghazi Al-Hamdan


    The authors hereby report a 21-year-old female who presented with the typical signs and topographic evidence of keratoconus in association with macular corneal dystrophy. Histopathologic evaluation from the excised corneal button after corneal transplant confirmed the diagnosis. To our knowledge, there is only one previous report in the literature linking the association of keratoconus and macular corneal dystrophy in the same eye bilaterally.

  14. Keratocyte apoptosis and corneal antioxidant enzyme activities after refractive corneal surgery. (United States)

    Bilgihan, K; Bilgihan, A; Adiguzel, U; Sezer, C; Yis, O; Akyol, G; Hasanreisoglu, B


    Refractive corneal surgery induces keratocyte apoptosis and generates reactive oxygen radicals (ROS) in the cornea. The purpose of the present study is to evaluate the correlation between keratocyte apoptosis and corneal antioxidant enzyme activities after different refractive surgical procedures in rabbits. Rabbits were divided into six groups. All groups were compared with the control group (Group 1), after epithelial scraping (Group 2), epithelial scrape and photorefractive keratectomy (PRK) (traditional PRK: Group 3), transepithelial PRK (Group 4), creation of a corneal flap with microkeratome (Group 5) and laser-assisted in situ keratomileusis (LASIK, Group 6). Terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling assay (to detect DNA fragmentation in situ) and light microscopy were used to detect apoptosis in rabbit eyes. Glutathione peroxidase (Gpx) and superoxide dismutase (SOD) activities of the corneal tissues were measured with spectrophotometric methods. Corneal Gpx and SOD activities decreased significantly in all groups when compared with the control group (P<0.05) and groups 2, 3 and 6 showed a significantly higher amount of keratocyte apoptosis (P<0.05). Not only a negative correlation was observed between corneal SOD activity and keratocyte apoptosis (cc: -0.3648) but Gpx activity also showed negative correlation with keratocyte apoptosis (cc: -0.3587). The present study illustrates the negative correlation between keratocyte apoptosis and corneal antioxidant enzyme activities. This finding suggests that ROS may be partly responsible for keratocyte apoptosis after refractive surgery.

  15. Analysis of the horizontal corneal diameter, central corneal thickness, and axial length in premature infants

    Directory of Open Access Journals (Sweden)

    Ozdemir Ozdemir


    Full Text Available Purpose: To determine the horizontal corneal diameter, central corneal thickness, and axial length in premature infants. Methods: Infants with a birth weight of less than 2,500 g or with a gestation period of less than 36 weeks were included in the study. Infants with retinopathy of prematurity (ROP were allocated to Group 1 (n=138, while those without ROP were allocated to Group 2 (n=236. All infants underwent a complete ophthalmologic examination, including corneal diameter measurements, pachymetry, biometry, and fundoscopy. Between-group comparisons of horizontal corneal diameter, central corneal thickness, and axial lengths were performed. Independent sample t-tests were used for statistical analysis. Results: Data was obtained from 374 eyes of 187 infants (102 female, 85 male. The mean gestational age at birth was 30.7 ± 2.7 weeks (range 25-36 weeks, the mean birth weight was 1,514 ± 533.3 g (range 750-1,970 g, and the mean postmenstrual age at examination was 40.0 ± 4.8 weeks. The mean gestational age and the mean birth weight of Group 1 were statistically lower than Group 2 (p0.05. Conclusions: The presence of ROP in premature infants does not alter the horizontal corneal diameter, central corneal thickness, or axial length.

  16. Pattern of corneal opacity in Ibadan, Nigeria | Ashaye | Annals of ...

    African Journals Online (AJOL)

    Background: The prevalence and causes of corneal blindness vary from one region of the world to another. There is even variation within the developing countries of Africa. Method: A retrospective review of 675 patients with corneal scarring out of the 3,753 new patients corneal scarring in patients attending the eye clinic of ...

  17. Detection of aldehyde dehydrogenase activity in human corneal extracts

    NARCIS (Netherlands)

    Gondhowiardjo, T. D.; van Haeringen, N. J.; Hoekzema, R.; Pels, L.; Kijlstra, A.


    The major soluble protein in bovine corneal epithelial extracts is a 54 kD protein (BCP 54) which has recently been identified as the corneal aldehyde dehydrogenase. Although ALDH activity has been reported in human corneal extracts it was not yet clear whether this was identical with the 54 kD

  18. A fibrin sealant for perforated and preperforated corneal ulcers.


    Lagoutte, F M; Gauthier, L; Comte, P R


    Fibrin sealant is used to close perforated or preperforated corneal ulcers. In addition to the usual advantages of cyanoacrylates it is degraded physiologically and provides a good support for corneal healing. Corneal grafting can be avoided when contraindicated or postponed when conditions allow. This technique has been successful in nine eyes of eight patients.

  19. Applications of biomaterials in corneal wound healing

    Directory of Open Access Journals (Sweden)

    I-Lun Tsai


    Full Text Available Disease affecting the cornea is a common cause of blindness worldwide. To date, the amniotic membrane (AM is the most widely used clinical method for cornea regeneration. However, donor-dependent differences in the AM may result in variable clinical outcomes. To overcome this issue, biomaterials are currently under investigation for corneal regeneration in vitro and in vivo. In this article, we highlight the recent advances in hydrogels, bioengineered prosthetic devices, contact lenses, and drug delivery systems for corneal regeneration. In clinical studies, the therapeutic effects of biomaterials, including fibrin and collagen-based hydrogels and silicone contact lenses, have been demonstrated in damaged cornea. The combination of cells and biomaterials may provide potential treatment in corneal wound healing in the future.

  20. Corneal versus ocular aberrations after overnight orthokeratology. (United States)

    Gifford, Paul; Li, Melanie; Lu, Helen; Miu, Jonathan; Panjaya, Monica; Swarbrick, Helen A


    To investigate relationships between changes to corneal and ocular aberrations induced by orthokeratology (OK) and their influence on visual function. Eighteen subjects (aged 20 to 23 years) were fitted with OK lenses (BE Enterprises Pty Ltd, Australia), manufactured in Boston XO material (Bausch & Lomb Boston, Wilmington, MA), and worn overnight for seven nights. Corneal and ocular aberrations were simultaneously captured (Discovery, Innovative Visual Systems, Elmhurst, IL), and contrast sensitivity function was measured on days 1 and 7, within 2 and 8 hours after lens removal on waking. Data from the eye achieving the higher myopic correction were analyzed for changes over time. There was a significant refractive effect at all visits. Orthokeratology induced an increase in corneal and ocular root mean square higher order aberrations (HOAs) and a positive shift in spherical aberration (SA) on day 1, with further increases by day 7. Increases in root mean square coma became significant by day 7. Changes to corneal and ocular SA were similar on day 1; however, by day 7, there was a greater increase in corneal than ocular SA, indicating a change in internal SA. Orthokeratology led to an overall decrease in contrast sensitivity function, which was isolated to spatial frequency changes on day 1 at 1 cycle per degree and on day 7 at 1 and 8 cycles per degree. A greater positive shift in corneal compared with ocular SA on day 7 suggests a negative shift in internal SA, which would be consistent with an increased accommodative response. Lack of any difference on day 1 indicates that this may be an ocular adaptation response toward neutralizing induced positive SA, rather than a direct effect of SA changes on the accommodation mechanism.

  1. Corneal nerve microstructure in Parkinson's disease. (United States)

    Misra, Stuti L; Kersten, Hannah M; Roxburgh, Richard H; Danesh-Meyer, Helen V; McGhee, Charles N J


    Ocular surface changes and blink abnormalities are well-established in Parkinson's disease. Blink rate may be influenced by corneal sub-basal nerve density, however, this relationship has not yet been investigated in Parkinson's disease. This case-control study examined the ocular surface in patients with moderately severe Parkinson's disease, including confocal microscopy of the cornea. Fifteen patients with moderately severe Parkinson's disease (modified Hoehn and Yahr grade 3 or 4) and fifteen control participants were recruited. Ophthalmic assessment included slit-lamp examination, blink rate assessment, central corneal aesthesiometry and in vivo corneal confocal microscopy. The effect of disease laterality was also investigated. Of the 15 patients with Parkinson's disease, ten were male and the mean age was 65.5±8.6years. The corneal sub-basal nerve plexus density was markedly reduced in patients with Parkinson's disease (7.56±2.4mm/mm 2 ) compared with controls (15.91±2.6mm/mm 2 ) (pParkinson's disease (0.79±1.2mBAR) and the control group (0.26±0.35mBAR), p=0.12. Sub-basal nerve density was not significantly different between the eye ipsilateral to the side of the body with most-severe motor symptoms, and the contralateral eye. There was a significant positive correlation between ACE-R scores and sub-basal corneal nerve density (R 2 =0.66, p=0.02). This is the first study to report a significant reduction in corneal sub-basal nerve density in Parkinson's disease and demonstrate an association with cognitive dysfunction. These results provide further evidence to support the involvement of the peripheral nervous system in Parkinson's disease, previously thought to be a central nervous system disorder. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Corneal epithelial inclusion cyst in a dog

    Directory of Open Access Journals (Sweden)

    Campos Carla de Freitas


    Full Text Available An unilateral corneal epithelial inclusion cyst in a 7-year-old male Boxer dog is reported. The cyst had been observed for thirty days, was unique, not congenital and only one eye was involved. Seven months prior to the referral the dog had manifested indolent corneal ulcer treated with grade keratotomy and third eyelid flap. The cyst was removed by superficial keratectomy followed by a conjunctival pedicle graft. Recovery was uncomplicated and there wasn?t recurrence seven months after the surgery.

  3. The corneal stroma during contact lens wear. (United States)

    Jalbert, Isabelle; Stapleton, Fiona


    Recent technological advances have lead to novel descriptions of the microanatomy of the corneal stroma. In the first section of this review, these findings and the role they play in the maintenance of vital properties such as corneal transparency, mechanical strength, homeostasis, wound-healing response and metabolism are described. In the second part, contact lens induced stromal alterations such as acidosis, oedema, striae, thinning and opacities are reviewed as well as the more recently described phenomenon of microdot deposits and keratocyte loss with an emphasis on how lens wearing stromal effects can be minimised.

  4. Current status of accelerated corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Michael Mrochen


    Full Text Available Corneal cross-linking with riboflavin is a technique to stabilize or reduce corneal ectasia, in diseases such as keratoconus and post-laser-assisted in situ keratomileusis (LASIK ectasia. There is an interest by patient as well as clinicians to reduce the overall treatment time. Especially, the introduction of corneal cross-linking in combination with corneal laser surgery demands a shorter treatment time to assure a sufficient patient flow. The principles and techniques of accelerated corneal cross-linking is discussed.

  5. Corneal-Wavefront guided transepithelial photorefractive keratectomy after corneal collagen cross linking in keratoconus

    Directory of Open Access Journals (Sweden)

    Massimo Camellin


    Conclusions: Corneal-Wavefront guided transepithelial PRK ablation profiles after conventional CXL yields to good visual, optical, and refractive results. These treatments are safe and efficacious for the correction of refracto-therapeutic problems in keratoconic patients.

  6. Corneal collagen crosslinking for keratoconus or corneal ectasia without epithelial debridement. (United States)

    Hirji, N; Sykakis, E; Lam, F C; Petrarca, R; Hamada, S; Lake, D


    Corneal collagen crosslinking (CXL) is a relatively new technique to reduce the progression of keratoconus. The technique can be performed with or without complete debridement of the corneal epithelium. We describe a novel intermediate technique involving mechanical disruption of the epithelium, and evaluate its safety and efficacy. The case notes of 128 eyes with progressive keratoconus or iatrogenic corneal ectasia who had undergone CXL using the epithelial disruption technique were retrospectively reviewed. Thin corneas were treated with hypotonic riboflavin. All others were treated with an isotonic solution. Note was made of preoperative and postoperative parameters, including uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, endothelial cell count, and corneal tomography. Occurrence of procedure-related complications was recorded. Statistical analyses were performed using the paired sample t-test and Wilcoxon signed-rank test, with a level of Pcorneal ectasia, and may be better tolerated by patients than the epithelium-off technique.

  7. Normative values for corneal nerve morphology assessed using corneal confocal microscopy: a multinational normative data set. (United States)

    Tavakoli, Mitra; Ferdousi, Maryam; Petropoulos, Ioannis N; Morris, Julie; Pritchard, Nicola; Zhivov, Andrey; Ziegler, Dan; Pacaud, Danièle; Romanchuk, Kenneth; Perkins, Bruce A; Lovblom, Leif E; Bril, Vera; Singleton, J Robinson; Smith, Gordon; Boulton, Andrew J M; Efron, Nathan; Malik, Rayaz A


    Corneal confocal microscopy is a novel diagnostic technique for the detection of nerve damage and repair in a range of peripheral neuropathies, in particular diabetic neuropathy. Normative reference values are required to enable clinical translation and wider use of this technique. We have therefore undertaken a multicenter collaboration to provide worldwide age-adjusted normative values of corneal nerve fiber parameters. A total of 1,965 corneal nerve images from 343 healthy volunteers were pooled from six clinical academic centers. All subjects underwent examination with the Heidelberg Retina Tomograph corneal confocal microscope. Images of the central corneal subbasal nerve plexus were acquired by each center using a standard protocol and analyzed by three trained examiners using manual tracing and semiautomated software (CCMetrics). Age trends were established using simple linear regression, and normative corneal nerve fiber density (CNFD), corneal nerve fiber branch density (CNBD), corneal nerve fiber length (CNFL), and corneal nerve fiber tortuosity (CNFT) reference values were calculated using quantile regression analysis. There was a significant linear age-dependent decrease in CNFD (-0.164 no./mm(2) per year for men, P < 0.01, and -0.161 no./mm(2) per year for women, P < 0.01). There was no change with age in CNBD (0.192 no./mm(2) per year for men, P = 0.26, and -0.050 no./mm(2) per year for women, P = 0.78). CNFL decreased in men (-0.045 mm/mm(2) per year, P = 0.07) and women (-0.060 mm/mm(2) per year, P = 0.02). CNFT increased with age in men (0.044 per year, P < 0.01) and women (0.046 per year, P < 0.01). Height, weight, and BMI did not influence the 5th percentile normative values for any corneal nerve parameter. This study provides robust worldwide normative reference values for corneal nerve parameters to be used in research and clinical practice in the study of diabetic and other peripheral neuropathies. © 2015 by the American Diabetes Association

  8. Groups, rings, modules

    CERN Document Server

    Auslander, Maurice


    This classic monograph is geared toward advanced undergraduates and graduate students. The treatment presupposes some familiarity with sets, groups, rings, and vector spaces. The four-part approach begins with examinations of sets and maps, monoids and groups, categories, and rings. The second part explores unique factorization domains, general module theory, semisimple rings and modules, and Artinian rings. Part three's topics include localization and tensor products, principal ideal domains, and applications of fundamental theorem. The fourth and final part covers algebraic field extensions

  9. Birth Control Ring (United States)

    ... Staying Safe Videos for Educators Search English Español Birth Control Ring KidsHealth / For Teens / Birth Control Ring What's in this article? What Is ... español Anillo vaginal anticonceptivo What Is It? The birth control ring is a soft, flexible, doughnut-shaped ...

  10. Relationship between Central Corneal Thickness, Vitreous ...

    African Journals Online (AJOL)

    Navarro R. The Optical Design of the Human Eye: a Critical Review J Optom. 2009; 2(1): 3–18. 2. David B, Fabrice M, Arthur H, Noel Z, Alexandre M. R, Rakhi J, Adriana A, ..... Mohamed H, Jorge LA, Pascual C, Walid HA, Juan JP. Relationship between Anterior Chamber Depth, Refractive State, Corneal Diameter, and Axial ...

  11. Corneal topography measurements for biometric applications (United States)

    Lewis, Nathan D.

    The term biometrics is used to describe the process of analyzing biological and behavioral traits that are unique to an individual in order to confirm or determine his or her identity. Many biometric modalities are currently being researched and implemented including, fingerprints, hand and facial geometry, iris recognition, vein structure recognition, gait, voice recognition, etc... This project explores the possibility of using corneal topography measurements as a trait for biometric identification. Two new corneal topographers were developed for this study. The first was designed to function as an operator-free device that will allow a user to approach the device and have his or her corneal topography measured. Human subject topography data were collected with this device and compared to measurements made with the commercially available Keratron Piccolo topographer (Optikon, Rome, Italy). A third topographer that departs from the standard Placido disk technology allows for arbitrary pattern illumination through the use of LCD monitors. This topographer was built and tested to be used in future research studies. Topography data was collected from 59 subjects and modeled using Zernike polynomials, which provide for a simple method of compressing topography data and comparing one topographical measurement with a database for biometric identification. The data were analyzed to determine the biometric error rates associated with corneal topography measurements. Reasonably accurate results, between three to eight percent simultaneous false match and false non-match rates, were achieved.

  12. Serological profile of candidates for corneal donation

    Directory of Open Access Journals (Sweden)

    Adroaldo Lunardelli


    Full Text Available Objetive: The purpose of this study is to map the serological profile of candidates to corneal donation at Irmandade Santa Casa de Misericórdia de Porto Alegre, identifying the percentage of disposal by serology and the marker involved. Methods: There have been analised – retrospectively – the results of serology of all corneal donors, made between the period of 1st january 2006 and 31st december 2012. Data analised were related to age, gender and the results of serology pertinent to viral markers (HBsAg, anti-HBc, anti-HCV and anti-HIV, these, determined by immunosorbent tests (ELISA. Results: In the period of the study, there were 2476 corneal donors at the institution, with a major incidence on the male gender, on an average of 58.7 years old. 23% of retention because of serological unfitness was also identified, that is, 570 samples were non-negative to any of the used tests. The marker anti- HBc was the most prevalent on the studied population, followed by the Hepatitis C virus (HCV and by the Human Immunodeficiency Virus (HIV. Conclusion: From the data found through this study, it is essential to have the participation of an efficient service on the serological evaluation of the candidates to corneal donation, once the security of the receptor must be taken into consideration in a population of donors with 23% of unfitness prevalence, in which the most prevalent marker is the one of Hepatits B.

  13. Relationship between Central Corneal Thickness, Vitreous ...

    African Journals Online (AJOL)

    The central corneal thickness (CCT), Vitreous chamber depth (VCD) and axial length (AL) are important ocular parameters used in the assessment of ocular health in relation to some ocular morbidities. Determining the differences in these parameters in relation to each other is fundamental to understanding the general eye ...

  14. Inhibition of Corneal Neovascularization by Hydrazinocurcumin

    African Journals Online (AJOL)

    This article previously published in Volume 15 Issue 2 of this journal in February 2016 has been retracted in line with the guidelines from the Committee on Publication Ethics (COPE, Retracted: Zhan W, Zhu J, Zhang Y. Inhibition of corneal neovascularization by ...

  15. Mathematical analysis of corneal oxygenation | Avtar | International ...

    African Journals Online (AJOL)

    Purpose: To develop a quasi steady state model for the time course concentration profile describing the oxygen diffusion and consumption in a multilayered corneal tissue and investigate the effect of various model parameters on the oxygen concentration for open and closed eyes. Method: A simple mathematical model for ...

  16. Retracted: Inhibition of Corneal Neovascularization by ...

    African Journals Online (AJOL)

    This article previously published in Volume 15 Issue 2 of this journal in February 2016 has been retracted in line with the guidelines from the Committee on Publication Ethics (COPE, Retracted: Zhan W, Zhu J, Zhang Y. Inhibition of corneal neovascularization by ...

  17. Ultraviolet induced lysosome activity in corneal epithelium

    International Nuclear Information System (INIS)

    Cullen, A.P.


    A 5.000 W Xe-Hg high pressure lamp and a double monochromator were used to produce a 3.3 nm half-bandpass ultraviolet radiation at 295 nm. Pigmented rabbit eyes were irradiated with radiant exposures from 140 Jm -2 to 10.000 Jm -2 and evaluated by slit-lamp biomicroscopy, light and electron microscopy. Corneal threshold (Hsub(c) was 200 Jm -2 and lens threshold (Hsub(L)) was 7.500 Jm -2 . The most repeatable and reliable corneal response to these levels of UV was the development of corneal epithelial granules. Histological changes included a loss of superficial epithelial cells and selective UV induced autolysis of the wing cells. It is suggested that the biomicroscopically observed granules are the clinical manifestation of the secondary lysosomes revealed by light and electron microscopy. It is proposed that UV breaks down the primary lysosome membranes to release hydrolytic enzymes which in turn form the secondary lysosomes during autolysis. Extreme levels of radiant exposure at 295 nm result in indiscriminate destruction of all layers of the corneal epithelium, but the posterior cornea was spared. (orig.) [de

  18. Management of Corneal Bee Sting Injuries. (United States)

    Rai, Ruju R; Gonzalez-Gonzalez, Luis A; Papakostas, Thanos D; Siracuse-Lee, Donna; Dunphy, Robert; Fanciullo, Lisa; Cakiner-Egilmez, Tulay; Daly, Mary K


    To review the management of keratitis after corneal bee stings and to report a case of deep stromal corneal infiltrate secondary to a retained bee stinger managed conservatively in a patient who presented three days after unsanitary manipulation of the stinger apparatus. Case report and review of literature. A 57-year-old male beekeeper was evaluated for pain, blurry vision, and photosensitivity after a corneal bee sting. Of note, the venom sac had been removed with dirty tweezers three days prior to his visit. On exam, a focal infiltrate with diffuse edema was seen surrounding a retained bee stinger in the peripheral cornea. Trace cells in the anterior chamber were also noted. Based on a high suspicion for infectious keratitis, a conservative treatment strategy was elected. Administration of broad-spectrum topical antibiotics with concomitant abstention of corticosteroids led to rapid resolution of the symptoms. Over 16 months of follow-up, the stinger has remained in situ without migration and the patient has maintained 20/20 visual acuity without complications. There is debate on the preferred method for the management of corneal injury secondary to bee stings, especially when it is associated with a retained stinger. We herein present our findings in our appraisal of reported cases. In the aftermath of an ocular bee sting, close surveillance for inflammation and infection is essential. Individual manifestations of these injuries vary in timing, type, and severity; therefore, the accessibility of the stinger and the evolving clinical picture should guide therapeutic decisions.

  19. Corneal Intelligence | Murdoch | Nigerian Journal of Ophthalmology

    African Journals Online (AJOL)

    Nigerian Journal of Ophthalmology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 19, No 1 (2011) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Corneal Intelligence. I Murdoch. Abstract. No Abstract.

  20. The Relationship between Central Corneal Thickness and ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the relationship between central corneal thickness (CCT) and intraocular pressure (IOP) in a predominantly black population. A total of eighty-five subjects (right eyes) with mean age 44.7 ± 15.1 years consisting of 49 males and 36 females were recruited for this study. The central ...

  1. [Purulent corneal ulcers: etiology, pathogenesis, classification]. (United States)

    Kasparova, Evg A; Kasparova, Evg A


    Advanced purulent corneal ulcer, as well as abscess, is a serious vision-threatening condition notable for its fulminant course and possible loss of the eye due to endophthalmitis. Its leading causes, pathogenesis, and classifications are described and analyzed in this paper.

  2. Polysaccharide coating of human corneal endothelium

    DEFF Research Database (Denmark)

    Schroder, H D; Sperling, S


    Electron microscopy revealed the presence of a 600-1500 A thick layer of polysaccharide on the surface of human corneal endothelial cells. The surface layer was visualized by combined fixation and staining in a mixture of ruthenium red and osmium tetroxide. The coating material was stable...

  3. Corneal ulcers: For the general practitioner

    African Journals Online (AJOL)

    may be important predisposing factors and give clues as to the aetiology. Contact lens use is a very common cause of corneal ulcers. Tools for examination. In general practice it is presumed that a slit-lamp and other specialised equipment is unavailable. It would be reasonable to have the following ophthalmic tools at one's ...

  4. A brief history of corneal transplantation: From ancient to modern

    Directory of Open Access Journals (Sweden)

    Alexandra X Crawford


    Full Text Available This review highlights many of the fundamental concepts and events in the development of corneal transplantation - from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date back to the Greek physician Galen (130-200 AD. Although proposals to provide improved corneal clarity by surgical interventions, including keratoprostheses, were better developed by the 17 th and 18 th centuries, true scientific and surgical experimentation in this field did not begin until the 19 th century. Indeed, the success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas, experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger initiated experimental animal corneal transplantation in 1818, coining the term "keratoplasty". Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger, 1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal xenograft on a human was reported shortly thereafter in 1838-unsurprisingly this was unsuccessful. Further progress in corneal transplantation was significantly hindered by limited understanding of antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable ophthalmologists have contributed to the development and refinement of corneal transplantation aided by the development of surgical microscopes, refined suture materials, the development of eye banks, and the introduction of

  5. Research on mouse model of grade II corneal alkali burn

    Directory of Open Access Journals (Sweden)

    Jun-Qiang Bai


    Full Text Available AIM: To choose appropriate concentration of sodium hydroxide (NaOH solution to establish a stable and consistent corneal alkali burn mouse model in grade II. METHODS: The mice (n=60 were randomly divided into four groups and 15 mice each group. Corneal alkali burns were induced by placing circle filter paper soaked with NaOH solutions on the right central cornea for 30s. The concentrations of NaOH solutions of groups A, B, C, and D were 0.1 mol/L, 0.15 mol/L , 0.2 mol/L, and 1.0 mol/L respectively. Then these corneas were irrigated with 20 mL physiological saline (0.9% NaCl. On day 7 postburn, slit lamp microscope was used to observe corneal opacity, corneal epithelial sodium fluorescein staining positive rate, incidence of corneal ulcer and corneal neovascularization, meanwhile pictures of the anterior eyes were taken. Cirrus spectral domain optical coherence tomography was used to scan cornea to observe corneal epithelial defect and corneal ulcer. RESULTS: Corneal opacity scores ( were not significantly different between the group A and group B (P=0.097. Incidence of corneal ulcer in group B was significantly higher than that in group A (P=0.035. Incidence of corneal ulcer and perforation rate in group B was lower than that in group C. Group C and D had corneal neovascularization, and incidence of corneal neovascularization in group D was significantly higher than that in group C (P=0.000. CONCLUSION: Using 0.15 mol/L NaOH can establish grade II mouse model of corneal alkali burns.

  6. New corneal findings in chromosome 10 deletion syndrome: report of two cases of corneal ectasia of varying severity. (United States)

    Lim, Lik Thai; Rehman, Ajmal; Masoud, Mohammad Tahir; Jaiya, Amrita; Tan, Peng Yi; Scott, J Angus


    To describe corneal changes associated with chromosome 10 terminal deletion (chromosome 10, monosomy 10qter) syndrome. Report of two cases of bilateral corneal ectasia with literature review. Corneal pathology has not previously been reported in the limited number of case reports on 10qter syndrome. However, Rodrigues et al.(1) have reported sclerocornea in 10q translocation. Ophthalmic manifestations of 10qter syndrome include strabismus, lid, and facial anomalies. We present two cases of corneal ectasia of varying severity. Possible etiologies include the following: secondary to genetic factors, acquired corneal exposure during sleep, or possible intrinsic immunocompromise exacerbating ocular surface infections. Corneal ectasia with specific histological changes is a feature of various genetic disorders (e.g., Down's, Ehler's Danlos, and Marfan's syndromes). It is unknown whether genetics plays a role in the development of corneal changes in 10qter syndrome. Management of inflammation and visual rehabilitation in these patients poses a therapeutic challenge.

  7. [Corneal ulcers in systemic autoimmunologic diseases]. (United States)

    Augsten, R; Dawczynski, J; Voigt, U; Oelzner, P; Schulze, E; Königsdörffer, E


    Keratolysis is a rare severe complication following systemic autoimmunologic diseases. Despite of complex therapeutic treatments, the prognosis is very poor. Ten eyes from seven patients with corneal ulcers were reported (age 45 - 73 years, mean 63 years; 6 women, 1 man). The corneal ulcer was perforated in 7 eyes. Five patients suffered from rheumatoid arthritis, and one patient developed a Sjögren's syndrome. Besides, one patient had shown both autoimmunologic diseases. After clinical attendance, visual acuity in the eyes with nonperforated ulcers was between 0.1 and 0.4, and in the eyes with perforated ulcers between light perception and 0.2. In 7 eyes with perforated corneal ulcers an emergency tectonic conjunctival plasty and, 1 - 2 days later, a keratoplasty had been performed. Postoperatively, local therapies had been initiated with antibiotic and immunosuppressive eyedrops as well as with conventional drops for dry-eye symptoms. Because of the autoimmunologic diseases of the patients, a systemic immunosuppressive therapy had been arranged. Follow-up period had been between 4 weeks and 3,5 years (mean 16 months). In the three eyes with nonperforated ulcers which received an antibiotic and immunosuppressive treatment, visual acuity was found at 1 / 20 and 0.4. However, in spite of stabilized findings in the 5 eyes with perforated ulcers, the visual acuity was in this case only between light perception and 0.05. One patient with a perforated ulcer and one patient with a recurrent corneal perforation after keratoplasty refused further operative procedures. Finally, both eyes had to undergo evisceration. Despite of intensive local and systemic immunosuppressive as well as operative therapies, corneal ulcers associated with autoimmunologic diseases (rheumatoid arthritis, Sjögren's syndrome) may cause a marked decrease of visual acuity or the loss of an eye. With regard to the healthy eye, an immunosuppressive therapy for life is most important.

  8. Physics of quantum rings

    CERN Document Server

    Fomin, Vladimir M


    This book deals with a new class of materials, quantum rings. Innovative recent advances in experimental and theoretical physics of quantum rings are based on the most advanced state-of-the-art fabrication and characterization techniques as well as theoretical methods. The experimental efforts allow to obtain a new class of semiconductor quantum rings formed by capping self-organized quantum dots grown by molecular beam epitaxy. Novel optical and magnetic properties of quantum rings are associated with non-trivial topologies at the nanoscale. An adequate characterization of quantum rings is po

  9. Femtosecond laser-assisted implantation of complete versus incomplete rings for keratoconus treatment. (United States)

    Hosny, Mohamed; El-Mayah, Esraa; Sidky, Mohamed Karim; Anis, Mohamed


    To compare complete versus incomplete ring implantation for keratoconus correction. We investigated 25 eyes of keratoconic patients, of which 15 had femtosecond-assisted MyoRing corneal implantation (Group 1) and 10 had femtosecond-assisted Keraring segments (Group 2). Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), mean K (K m), sphere, topographic cylinder, and corneal asphericity value (Q-value) were measured in all eyes preoperatively and at 4 weeks postoperatively (1 month). In Group 1, the K m change was -6.15±2.16 D, with a mean change in sphere of 4.45±2.18 D and a mean change in refractive cylinder of 2.32±3 D. UCVA change was -0.57±0.273 logarithm of the minimum angle of resolution (LogMAR), BCVA change was -0.2±0.27 (LogMAR), and the Q-value change was 0.43±2.6. In Group 2, the K m change was -3.15±1.68 D, UCVA change was -0.48±0.37 (LogMAR), BCVA change was -0.09±0.15 (LogMAR), and the Q-value change was 0.5±0.21. Changes in the means did not significantly differ between groups, except for the K m change, which was significantly greater in Group 1 than in Group 2 (P=0.05). Both complete ring and ring segment implantation are effective for improving corneal and visual parameters in keratoconus. Complete ring implantation may have a greater flattening effect on the anterior corneal surface.

  10. Bilateral corneal ulceration in ocular graft-versus-host disease. (United States)

    Stevenson, William; Shikari, Hasanain; Saboo, Ujwala S; Amparo, Francisco; Dana, Reza


    To report on corneal ulceration in ocular graft-versus-host disease (GVHD). This was a retrospective, observational case series investigating corneal ulceration and perforation in a cohort of ocular GVHD patients seen between June 2007 and October 2012. Four of 243 ocular GVHD patients developed corneal ulcerations attributable to ocular GVHD, and all four cases involved bilateral corneal ulceration. The median length of time from the diagnosis of ocular GVHD to the diagnosis of the first corneal ulceration was 317 days (range 168-434). The median length of time between the diagnosis of corneal ulceration in each patient's first and second eye was 248 days (range 9-645). Outcomes varied from complete resolution with medical treatment to corneal perforation necessitating penetrating keratoplasty. In cases of corneal perforation, the median length of time from the diagnosis of corneal ulceration to perforation was 10 days (range 0-20). Common clinical features included: centrally or paracentrally located ulcerations and perforations, concomitant dry eye, and the use of topical or systemic corticosteroids. Frequent follow-up and bilateral monitoring are highly recommended in cases of ocular GVHD-associated stromal thinning, as bilateral involvement or rapid progression to corneal perforation can occur.

  11. Corneal neurotization: a novel technique for the anesthetic cornea. (United States)

    Terzis, Julia K; Dryer, Marylou M; Bodner, Bruce I


    This report describes and evaluates the efficacy of a novel procedure, direct corneal neurotization using contralateral, supraorbital, and supratrochlear nerves in patients with unilateral facial palsy and corneal anesthesia. The charts of 6 patients were thoroughly reviewed. Evaluated outcome parameters included corneal sensibility, improvement in best-corrected visual acuity, blink reflex, donor deficit, synesthesia, long-term corneal health, several psychosocial measures, and overall patient satisfaction. The mean age at time of surgery in our study was 41.7 +/- 9.07 years. Average time from denervation to surgery was 7.00 +/- 8.56 years with an average follow-up time of 16.3 +/- 2.42 years. After surgery, all 6 eyes showed improvement of corneal sensibility, visual acuity, and corneal health and remained free of ulcers without adjunctive surgical treatment. Average time to sensibility was 2.80 +/- 2.17 years, and average corneal sensibility improved from 2.00 +/- 4.47 mm before surgery to 27.8 +/- 22.6 mm after corneal neurotization (P corneal sensibility in patients with unilateral facial palsy and anesthetic cornea. This procedure preserves ocular anatomy and cosmesis while restoring function by improving corneal health and visual acuity and by reestablishing the blink reflex.

  12. Cytopathic effect of Acanthamoeba on human corneal fibroblasts (United States)

    Takaoka-Sugihara, Noriko; Yokoo, Seiichi; Matsubara, Masao; Yagita, Kenji


    Purpose Acanthamoeba keratitis is associated with keratocyte depletion in humans. We investigated how Acanthamoebae isolated from corneas affected by Acanthamoeba keratitis interacted with human corneal stromal cells in vitro. Methods Acanthamoebae were isolated from 6 patients with Acanthamoeba keratitis and genotyping was done. Whether the isolated Acanthamoebae could invade the corneal stroma was assessed with denuded corneal stroma ex vivo. The cytopathic effect of Acanthamoeba on cultured corneal fibroblasts from donor corneas was quantitatively evaluated by the MTT assay after culture under various conditions. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) and Annexin V staining were employed to detect apoptotic cells among the corneal fibroblasts co-cultured with Acanthamoebae. Results All 6 Acanthamoebae isolated from the patients with Acanthamoeba keratitis were shown to have the T4 genotype by 18S rDNA sequence analysis. Acanthamoebae invaded the denuded corneal stroma in the ex vivo experiments and had a cytopathic effect on human corneal fibroblasts after direct adhesion, but not via chemical mediators. A cytopathic effect was detected with all 6 Acanthamoebae and corneal fibroblasts mainly died by apoptosis, as evidenced by Annexin V staining. Conclusions Acanthamoebae isolated from patients with Acanthamoeba keratitis had a cytopathic effect on human corneal fibroblasts, mainly via induction of apoptosis after direct adhesion. Our findings may provide some clues to the pathophysiology of corneal keratocyte depletion in patients with Acanthamoeba keratitis. PMID:22933834

  13. Anatomical characterization of central, apical and minimal corneal thickness

    Directory of Open Access Journals (Sweden)

    Federico Saenz-Frances


    Full Text Available AIM: To anatomically locate the points of minimum corneal thickness and central corneal thickness (pupil center in relation to the corneal apex.METHODS: Observational, cross-sectional study, 299 healthy volunteers. Thickness at the corneal apex (AT, minimum corneal thickness (MT and corneal thickness at the pupil center (PT were determined using the pentacam. Distances from the corneal apex to MT (MD and PT (PD were calculated and their quadrant position (taking the corneal apex as the reference determined:point of minimum thickness (MC and point of central thickness (PC depending on the quadrant position. Two multivariate linear regression models were constructed to examine the influence of age, gender, power of the flattest and steepest corneal axes, position of the flattest axis, corneal volume (determined using the Pentacam and PT on MD and PD. The effects of these variables on MC and PC were also determined in two multinomial regression models.RESULTS: MT was located at a mean distance of 0.909 mm from the apex (79.4% in the inferior-temporal quadrant. PT was located at a mean distance of 0.156 mm from the apex. The linear regression model for MD indicated it was significantly influenced by corneal volume (B=-0.024; 95%CI:-0.043 to -0.004. No significant relations were identified in the linear regression model for PD or the multinomial logistic regressions for MC and PC.CONCLUSION: MT was typically located at the inferior-temporal quadrant of the cornea and its distance to the corneal apex tended to decrease with the increment of corneal volume.

  14. Corneal biomechanical features in patients with ankylosing spondylitis. (United States)

    Cabuk, Kubra Serefoglu; Üstün, Emine Isil; Atalay, Kursat; Kirgiz, Ahmet; Aydin, Rukiye


    To evaluate the corneal biomechanical features and central corneal thickness in ankylosing spondylitis patients and to evaluate correlations of these parameters with disease activity. The study included 51 patients diagnosed with ankylosing spondylitis (mean age, 40.80 ± 13.15 years; range, 18-72 years) and 34 age- and sex-matched healthy controls (mean age, 42.00 ± 12.32 years; range, 18-60 years). All underwent a complete ophthalmological and physical examination, including visual acuity testing and biomicroscopic anterior and posterior segment examinations. Corneal hysteresis, corneal resistance factor, Goldmann-correlated intraocular pressure, and corneal compensated intraocular pressure were evaluated with an ocular response analyzer, and the central corneal thickness was measured with Sirius® corneal tomography. The Bath Ankylosing Spondylitis Disease Activity Index, Functional Index, and Metrology Index scores were recorded. In the ankylosing spondylitis patients, the mean disease duration was 7.73 ± 6.05 (range, 1-30) years. There was no statistically significant difference between the patients and controls in the corneal biomechanical features. The Goldmann-correlated intraocular pressure and corneal compensated intraocular pressure both showed positive correlations with age (p=0.003 and p=0.001, res-pectively). There was a negative correlation between corneal hysteresis and disease duration (p=0.002), and between central corneal thickness and the Bath Ankylosing Spondylitis Metrology Index score (p=0.003). This study demonstrated a significant negative correlation between corneal hysteresis and disease duration in ankylosing spondylitis patients. Furthermore, the central corneal thickness value decreased with an increase in Bath Ankylosing Spondylitis Metrology Index score, which may result in an underestimate of intraocular pressure readings and thus an inaccurate risk assessment of glaucoma.

  15. Corneal collagen cross-linking to stop corneal ectasia exacerbated by radial keratotomy. (United States)

    Mazzotta, Cosimo; Baiocchi, Stefano; Denaro, Rosario; Tosi, Gian Marco; Caporossi, Tomaso


    To assess the efficacy of riboflavin ultraviolet A (UV-A) corneal collagen cross-linking in the management of keratoconic corneal ectasia exacerbated by radial keratotomy (RK). A patient with progressive corneal ectasia and hyperopic shift, occurring 10 years after RK performed in the left eye, was treated with riboflavin UV-A corneal collagen cross-linking according to the Siena protocol: Pilocarpin 0.1% drop (1 hour before), lidocaine 4% drops 15 minutes before, mechanical scraping of epithelium (9-mm-diameter area), preirradiation stromal soaking for 10 minutes in riboflavin 0.1%-dextrane 20% (Ricrolin; Sooft Italy) applied every 2 minutes, and 30 minutes of total exposure (6 steps of 5 minutes) to solid-state UV-A illuminator (Caporossi, Baiocchi, Mazzotta Vega X linker; CSO Opthalmics, Florence, Italy), energy delivered 3 mW/cm, and irradiated area 9 mm in diameter. After the operation, uncorrected visual acuity and best spectacle-corrected visual acuity improved from 0.2 to 0.6 and from 0.3 to 0.8 Snellen lines, respectively, in a 12-month follow-up. Improved topographical K readings and corneal symmetry index were also recorded starting from the first postoperative month and continuing thereafter. No adverse effects were recorded after treatment. Riboflavin UV-A-induced corneal cross-linking seems to be a promising surgical option in the management of unstable corneal ectasia exacerbated by RK, particularly in eyes with preexisting keratoconus. A large cohort and longer follow-up are needed to determine its long-term efficacy in this clinical setting.

  16. Adipose Derived Stem Cells for Corneal Wound Healing after Laser Induced Corneal Lesions in Mice

    Directory of Open Access Journals (Sweden)

    Marco Zeppieri


    Full Text Available The aim of our study was to assess the clinical effectiveness of topical adipose derived stem cell (ADSC treatment in laser induced corneal wounds in mice by comparing epithelial repair, inflammation, and histological analysis between treatment arms. Corneal lesions were performed on both eyes of 40 mice by laser induced photorefractive keratectomy. All eyes were treated with topical azythromycin bid for three days. Mice were divided in three treatment groups (n = 20, which included: control, stem cells and basic serum; which received topical treatment three times daily for five consecutive days. Biomicroscope assessments and digital imaging were performed by two masked graders at 30, 54, 78, 100, and 172 h to analyze extent of fluorescein positive epithelial defect, corneal inflammation, etc. Immunohistochemical techniques were used in fixed eyes to assess corneal repair markers Ki67, α Smooth Muscle Actin (α-SMA and E-Cadherin. The fluorescein positive corneal lesion areas were significantly smaller in the stem cells group on days 1 (p < 0.05, 2 (p < 0.02 and 3. The stem cell treated group had slightly better and faster re-epithelization than the serum treated group in the initial phases. Comparative histological data showed signs of earlier and better corneal repair in epithelium and stromal layers in stem cell treated eyes, which showed more epithelial layers and enhanced wound healing performance of Ki67, E-Cadherin, and α-SMA. Our study shows the potential clinical and histological advantages in the topical ADSC treatment for corneal lesions in mice.

  17. Unilateral corneal leukoplakia without limbal involvement

    Directory of Open Access Journals (Sweden)

    Hirano K


    Full Text Available Koji Hirano,1 Mihoko Koide,2 Yoshikazu Mizoguchi,3 Yasuhiro Osakabe,4 Kaoru-Araki Sasaki5 1Department of Ophthalmology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 2Koide Internal Medicine and Eye Clinic, Nagoya, Japan; 3Department of Pathology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Nagoya, Japan; 4Department of Molecular Pathology, Tokyo Medical University, Tokyo, Japan; 5Department of Ophthalmology, Japan Health Care Organization, Hoshigaoka Medical Center, Hirakata, Japan Purpose: Leukoplakia is the term given to a white patch or plaque that is found mainly on the oral mucus membrane. It can occasionally be seen on the corneal surface. We report our clinical and histopathological findings in a case of unilateral corneal leukoplakia. Methods: A 26-year-old woman was referred to our hospital because of a white patch on her right cornea that continued to expand. She first noticed the white patch when she was 20 years old, and the white patch had expanded to cover the pupillary area affecting her vision. After plastic surgery on both eyelids for bilateral entropion to alleviate the pain caused by the eyelashes rubbing the cornea, the white corneal patch decreased in size. Because of this reduction, we performed surgery to remove the patch with microforceps under topical anesthesia. The plaque was removed easily and completely, and submitted for histopathological examination. Results: Histopathological examination showed that the specimen had characteristics of epidermis with a basal cell layer, spinous cell layer, granular cell layer, and horny layer with hyperkeratosis. She was diagnosed with leukoplakia of the corneal surface. The basic structure of the squamous cell layer was preserved, and there were no signs of metaplasia. Six months after the removal of the leukoplakia, no recurrence was seen and her corrected decimal visual acuity recovered to 1

  18. Ciliary neurotrophic factor promotes the activation of corneal epithelial stem/progenitor cells and accelerates corneal epithelial wound healing. (United States)

    Zhou, Qingjun; Chen, Peng; Di, Guohu; Zhang, Yangyang; Wang, Yao; Qi, Xia; Duan, Haoyun; Xie, Lixin


    Ciliary neurotrophic factor (CNTF), a well-known neuroprotective cytokine, has been found to play an important role in neurogenesis and functional regulations of neural stem cells. As one of the most innervated tissue, however, the role of CNTF in cornea epithelium remains unclear. This study was to explore the roles and mechanisms of CNTF in the activation of corneal epithelial stem/progenitor cells and wound healing of both normal and diabetic mouse corneal epithelium. In mice subjecting to mechanical removal of corneal epithelium, the corneal epithelial stem/progenitor cell activation and wound healing were promoted by exogenous CNTF application, while delayed by CNTF neutralizing antibody. In cultured corneal epithelial stem/progenitor cells, CNTF enhanced the colony-forming efficiency, stimulated the mitogenic proliferation, and upregulated the expression levels of corneal epithelial stem/progenitor cell-associated transcription factors. Furthermore, the promotion of CNTF on the corneal epithelial stem/progenitor cell activation and wound healing was mediated by the activation of STAT3. Moreover, in diabetic mice, the content of CNTF in corneal epithelium decreased significantly when compared with that of normal mice, and the supplement of CNTF promoted the diabetic corneal epithelial wound healing, accompanied with the advanced activation of corneal epithelial stem/progenitor cells and the regeneration of corneal nerve fibers. Thus, the capability of expanding corneal epithelial stem/progenitor cells and promoting corneal epithelial wound healing and nerve regeneration indicates the potential application of CNTF in ameliorating limbal stem cell deficiency and treating diabetic keratopathy. © 2014 AlphaMed Press.

  19. Ring Keratitis Associated With Topical Abuse of a Dilute Anesthetic After Refractive Surgery

    Directory of Open Access Journals (Sweden)

    Yu-Chih Hou


    Full Text Available Anesthetic toxic keratitis is rare and presents as a ring keratitis, which is often misdiagnosed as Acanthamoeba keratitis. Here, we report an unusual case of toxic keratitis caused by topical abuse of a dilute anesthetic. A 26-year-old woman presented with bilateral corneal edema, ring infiltrates, pigmented keratic precipitate, Descemet's membrane folding, and strong anterior chamber reactions 2 weeks after laser subepithelial keratomileusis surgery. Tracing back her medical history, topical dilute 0.1% proparacaine was prescribed and frequently used for 1 month. Toxic keratitis was suspected. After discontinuation of the topical anesthetic and initiation of treatment with topical 20% autologous serum, complete corneal epithelialization was achieved within 1 week. Corneal infiltrates and anterior chamber reaction gradually subsided. Vision improved from finger counting to 20/20 in the right eye and 20/25 in the left eye, but confocal microscopy showed decreased corneal endothelial cells. Topical abuse of a dilute topical anesthetic can cause severe toxic keratitis and endothelial cell loss. The physician must be aware of the signs of topical anesthetic abuse and should not prescribe even a dilute anesthetic for long-term use. Autologous serum can help in the recovery of toxic keratitis.

  20. Induction of corneal collagen cross-linking in experimental corneal alkali burns in rabbits

    Directory of Open Access Journals (Sweden)

    Marcello Colombo-Barboza


    Full Text Available Objective: To evaluate the effect of riboflavin-ultraviolet-A-induced cross-linking (CXL following corneal alkali burns in rabbits. Methods: The right corneas and limbi of ten rabbits were burned using a 1N solution of NaOH and the animals were then divided into two groups: a control group submitted to clinical treatment alone and an experimental group that was treated 1 h after injury with CXL, followed by the same clinical treatment as administered to the controls. Clinical parameters were evaluated post-injury at 1, 7, 15, and 30 days by two independent observers. Following this evaluation, the corneas were excised and examined histologically. Results: There were no statistically significant differences in clinical parameters, such as hyperemia, corneal edema, ciliary injection, limbal ischemia, secretion, corneal neovascularization, symblepharon, or blepharospasm, at any of the time-points evaluated. However, the size of the epithelial defect was significantly smaller in the CXL group (p<0.05 (day 15: p=0.008 and day 30: p=0.008 and the extent of the corneal injury (opacity lesion was also smaller (day 30: p=0.021. Histopathology showed the presence of collagen bridges linking the collagen fibers in only the CXL group. Conclusions: These results suggest that the use of CXL may improve the prognosis of acute corneal alkali burns.

  1. Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. (United States)

    Kohlhaas, Markus; Boehm, Andreas G; Spoerl, Eberhard; Pürsten, Antje; Grein, Hans J; Pillunat, Lutz E


    To evaluate the effect of central corneal thickness (CCT), corneal curvature, and axial length on applanation tonometry in an in vivo study. In a masked, prospective clinical trial, we examined 125 eyes of 125 patients scheduled for cataract surgery. Corneal curvature was measured by means of keratometry and axial length by A-scan ultrasonography. By cannulating the anterior chamber before surgery, intraocular pressure (IOP) was set to 20, 35, and 50 mm Hg in a closed system by means of a water column. After measuring thickness, the IOP was measured with an applanation tonometer. Pearson product moment correlations and multiple linear regression analyses were performed, and significance levels were evaluated by the paired, 2-tailed t test. The difference between measured and real IOP was significantly dependent (P < .001) on CCT. The associations between IOP and corneal curvature or IOP and axial length were not statistically significant (P = .31). The association between IOP reading and CCT is shown in the "Dresdner correction table," which illustrates an approximately 1-mm Hg correction for every 25-microm deviation from a CCT of 550 microm. The correction values were positive as thickness decreased and negative as thickness increased. Central corneal thickness significantly affects IOP readings obtained by applanation tonometry according to the Goldmann principle. A correction of IOP readings by considering CCT according to the Dresdner correction table might be helpful for determining an accurate IOP value.

  2. Corneal Shape, Volume, and Interocular Symmetry: Parameters to Optimize the Design of Biosynthetic Corneal Substitutes. (United States)

    Durr, Georges M; Auvinet, Edouard; Ong, Jeb; Meunier, Jean; Brunette, Isabelle


    To characterize the three-dimensional (3D) shape, volume distribution, and mirror symmetry of the right and left corneas at the scale of a large population, based on the integrated analysis of 3D corneal shape average maps and topography parameters. A total of 7670 Orbscan II corneal topographies from 3835 consenting subjects with no history of ocular disease were studied. Average topography maps were created using the right and left corneal topographies of all subjects. To quantify symmetry, left eye topographies were flipped horizontally into "right eye" topographies and statistics maps were generated, including difference and intraclass correlation coefficient (ICC) maps. The standard deviation of the anterior and posterior average elevation maps in the 3-mm radius central zone of the right and left corneas ranged within ± 8 μm and ± 44 μm, respectively. The ICC maps showed almost perfect interocular agreement for anterior elevation, posterior elevation, and pachymetry (all ICCs > 0.96). All studied shape parameters also showed excellent agreement (ICCs ≥ 0.80). Mirror symmetry was not affected by age, sex, or spherical equivalent. We also showed that this horizontal reflection (flip) of the right and left corneal shapes could not be replaced by a simple rotation. These results indicate that in normal eyes, the anterior elevation, posterior elevation, and pachymetry of the right and left corneas show remarkable symmetry. This comprehensive analysis was achieved with the purpose of guiding the development of future biosynthetic corneal substitutes.

  3. Epidemiological characteristics, predisposing factors and microbiological profiles of infectious corneal ulcers: the Portsmouth corneal ulcer study. (United States)

    Ibrahim, Y W; Boase, D L; Cree, I A


    The aim of the study was to identify the epidemiological characteristics, predisposing factors, and the clinical and microbiological diagnosis of infectious corneal ulcers in a population based in southern England. A retrospective review was undertaken of the medical records of patients presenting with infectious corneal ulcers at the eye casualty department of Queen Alexandra Hospital, Portsmouth, UK, between January 1997 and December 2003. A total of 1786 patients presented with infectious corneal ulcers, with a mean age of 45 years and female predominance (54.5%). Contact lens wear was the main predisposing factor in 554 patients (31%). Corneal scrapes from 1254 patients grew positive cultures in 800 patients. Gram-positive bacteria accounted for 696 (71.1%) of the total 979 bacterial isolates, while Gram-negative bacteria accounted for 283 (28.9%) with the predominance of Pseudomonas aeruginosa. Nine out of 11 patients with Acanthamoeba keratitis were contact lens wearers. The majority of patients 1728 (96.8%) sought medical help more than once and 34 patients (1.9%) had poor visual outcome. Follow-up was completed in 1633 patients (91.4%) with an average of 11.5 days. Wearing contact lenses remains the most important risk factor for infectious corneal ulcers. Reduction of the rate and severity of infectious keratitis requires continuous education of patients, and of professionals.

  4. [Peripheral corneal melting syndrome in psoriatic arthritis treated with adalimumab]. (United States)

    Restrepo, Juan Pablo; Medina, Luis Fernando; Molina, María del Pilar


    Peripheral corneal melting syndrome is a rare immune condition characterized by marginal corneal thinning and sometimes perforation. It is associated with rheumatic and non-rheumatic diseases. Few cases of peripheral corneal melting have been reported in patients with psoriasis. The pathogenesis is not fully understood but metalloproteinases may play a pathogenic role. Anti-TNF therapy has shown to decrease skin and serum metalloproteinases levels in psoriasis. We report a 61-year-old man with peripheral corneal melting syndrome associated with psoriatic arthritis who received Adalimumab to control skin and ocular inflammation. To our knowledge, this is the first case report of peripheral corneal melting syndrome in psoriatic arthritis treated with Adalimumab showing resolution of skin lesions and complete healing of corneal perforation in three months. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  5. Relationship between central and peripheral corneal astigmatism in elderly patients (United States)

    Kawamorita, Takushi; Shimizu, Kimiya; Hoshikawa, Rie; Kamiya, Kazutaka; Shoji, Nobuyuki


    Abstract Purpose We investigated the relationship between central and peripheral corneal astigmatism in elderly patients. Methods Seventy-six eyes of 76 elderly subjects (mean age = 72.6 ± 3.0 years) were included in the study. Corneal shape was evaluated using the Pentacam HR (Oculus, Wetzlark, Germany), which is comprised of a rotating Scheimpflug camera and a short-wavelength slit light. The power distribution map was selected and corneal astigmatism was calculated using front K-Readings in zones centered on the pupil. Analyzed zones were 2.0-6.0 mm in diameter. Results Corneal astigmatism decreased as diameter increased, similar to what was observed in eyes with with-the-rule astigmatism and against-the-rule astigmatism (ANOVA, p axis of corneal astigmatism (ANOVA, p = 0.98). Conclusion These results suggest that the relationship between central and peripheral corneal astigmatism should be taken into consideration to optimize vision when astigmatic correction is needed.

  6. [The status quo and expectation of corneal research in China]. (United States)

    Shi, Weiyun; Xie, Lixin


    In China, corneal disease is currently the second leading cause of blindness. Severe donor shortage, insufficient technique supports and promotion, and the lack of corneal disease specialists due to poor systematic training are all urgent problems to be resolved. The last 5 years have witnessed a considerable progress in basic and clinical researches of corneal disease. Investigations on the pathogenesis and treatment of fungal keratitis have won an international reputation. Results from the study of corneal reconstruction with tissue-engineered and acellular matrix corneas have been tested in clinical trials with good preliminary performance. Moreover, the clinical researches of corneal refractive surgery have kept pace with the latest international progresses. However, Descemet's membrane endothelial keratoplasty needs further promotion, and the development and application of keratoprosthesis remains a blank. Although keratoprosthesis and corneal collagen cross-linking have been widely applied in Europe with satisfactory clinical efficacy, they are still under assessment by China Food and Drug Administration for approval of use.

  7. [Corneal neurotrophic ulcers--clinical and etiopathogenic aspects]. (United States)

    Damian, Carmen; Craitoiu, Stefania; Preda, Mirela; Manescu, Rodica; Irimia, Anca; Marinescu, Florentina


    The aim of this paper is to observe the corneal neurotrophic ulcers in patients with ophthalmic and systemic diseases associated with impairment of the sensory innervation of the cornea. We have performed a retrospective study using a lot of patients with corneal neurotrophic ulcers, admitted in Ophthalmology Clinic in 2003-2006. We have analyzed the etiopathogenic factors that have determined the corneal trophic ulcers, the treatment and the complications occurred. The study spot-lighted two main causes responsible for the corneal trophic ulcers: ocular and systemic disorders. For many patients the etiopathogenic factor is multiple. 1. Corneal neurotrophic ulcer is a severe complication of an ophthalmic or a systemic disorder. 2. The moderate outcome of ophthalmic complications require early treatment, adjusted for each patient. 3. Prevention of the corneal neurotrophic ulcers is the best method of treatment.

  8. Systemic immunomodulatory strategies in high-risk corneal transplantation

    Directory of Open Access Journals (Sweden)

    Tulio B Abud


    Full Text Available The cornea is the most commonly transplanted tissue in the body. Although corneal grafts generally have high success rates, transplantation onto inflamed and vascularized host beds, or so-called high-risk corneal transplantation, has a high rate of graft rejection. The management of this high-risk corneal transplantation is challenging and involves numerous measures. One of the key measures to prevent graft rejection in these cases is the use of systemic immunosuppressive agents. In this article, we will review the systemic immunosuppressive agents most commonly used for high-risk corneal transplantation, which include corticosteroids, cysclosporine A, tacrolimus, mycophenolate mofetil, and rapamycin. Benefits, risks, and published data on the use of these medications for high-risk corneal transplantation will be detailed. We will also summarize novel immunoregulatory approaches that may be used to prevent graft rejection in high-risk corneal transplantation.

  9. Brane world black rings

    International Nuclear Information System (INIS)

    Sahay, Anurag; Sengupta, Gautam


    Five dimensional neutral rotating black rings are described from a Randall-Sundrum brane world perspective in the bulk black string framework. To this end we consider a rotating black string extension of a five dimensional black ring into the bulk of a six dimensional Randall-Sundrum brane world with a single four brane. The bulk solution intercepts the four brane in a five dimensional black ring with the usual curvature singularity on the brane. The bulk geodesics restricted to the plane of rotation of the black ring are constructed and their projections on the four brane match with the usual black ring geodesics restricted to the same plane. The asymptotic nature of the bulk geodesics are elucidated with reference to a bulk singularity at the AdS horizon. We further discuss the description of a brane world black ring as a limit of a boosted bulk black 2 brane with periodic identification

  10. Token Ring Project

    Directory of Open Access Journals (Sweden)

    Adela Ionescu


    Full Text Available Ring topology is a simple configuration used to connect processes that communicate among themselves. A number of network standards such as token ring, token bus, and FDDI are based on the ring connectivity. This article will develop an implementation of a ring of processes that communicate among themselves via pipe links. The processes are nodes in the ring. Each process reads from its standard input and writes in its standard output. N-1 process redirects the its standard output to a standard input of the process through a pipe. When the ring-structure is designed, the project can be extended to simulate networks or to implement algorithms for mutual exclusion

  11. Token ring technology report

    CERN Document Server


    Please note this is a Short Discount publication. This report provides an overview of the IBM Token-Ring technology and products built by IBM and compatible vendors. It consists of two sections: 1. A summary of the design trade-offs for the IBM Token-Ring. 2. A summary of the products of the major token-ring compatible vendors broken down by adapters and components, wiring systems, testing, and new chip technology.

  12. Spannungsgesteuerter Ring-Oszillator


    Wang, Z.; Thiede, A.


    The oscillator (1) of integrated monolithic design has several analogue amplifier units (2) connected in a ring. The individual amplifiers are frequency selective in regard to a resonance frequency. The phase displacements of the amplifiers are chosen so that the total phase displacement over the ring at the resonance frequencies of the amplifiers amounts to 3600 or a whole number multiple of that. The number of amplifiers selected corresponds to the overall quality factor for the ring oscill...

  13. Radioactive gold ring dermatitis

    Energy Technology Data Exchange (ETDEWEB)

    Miller, R.A.; Aldrich, J.E. (Dalhousie Univ., Halifax, Nova Scotia (Canada))


    A superficial squamous cell carcinoma developed in a woman who wore a radioactive gold ring for more than 30 years. Only part of the ring was radioactive. Radiation dose measurements indicated that the dose to basal skin layer was 2.4 Gy (240 rad) per week. If it is assumed that the woman continually wore her wedding ring for 37 years since purchase, she would have received a maximum dose of approximately 4600 Gy.

  14. Vortex and source rings

    DEFF Research Database (Denmark)

    Branlard, Emmanuel Simon Pierre


    The velocity field, vector potential and velocity gradient of a vortex ring is derived in this chapter. The Biot-Savart law for the vector potential and velocity is expressed in a first section. Then, the flow is derived at specific locations: on the axis, near the axis and in the far field where...... is dedicated to vortex rings. Source rings are only briefly mentioned....

  15. Radioactive gold ring dermatitis

    International Nuclear Information System (INIS)

    Miller, R.A.; Aldrich, J.E.


    A superficial squamous cell carcinoma developed in a woman who wore a radioactive gold ring for more than 30 years. Only part of the ring was radioactive. Radiation dose measurements indicated that the dose to basal skin layer was 2.4 Gy (240 rad) per week. If it is assumed that the woman continually wore her wedding ring for 37 years since purchase, she would have received a maximum dose of approximately 4600 Gy

  16. Corneal cross-linking treatment of keratoconus

    Directory of Open Access Journals (Sweden)

    Mahgol Farjadnia


    Full Text Available Keratoconus as the most common cause of ectasia is one of the leading cause of corneal transplants worldwide. The current available therapies do not modify the underlying pathogenesis of the disease, and none of the available approaches but corneal transplant hinder the ongoing ectasia. Several studies document Crosslink defect between collagen fibrils in the pathogenesis of keratoconus. Collagen cross link is a relatively new approach that with the application of the riboflavin and ultraviolet A, new covalent bands reform. Subjective and objective results following this method seem to be promising. Endothelial damage besides other deep structural injury, which is the major concern of this technique have not yet been reported, when applying the standard method.

  17. [Morphologic Corneal Changes after Crosslinking for Keratoconus]. (United States)

    Müller, P L; Löffler, K U; Kohlhaas, M; Holz, F G; Herwig-Carl, M C


    Keratoconus is a relatively common (1 : 2000) bilateral disease leading to a change in biochemical and biomechanical corneal structure as well as thinning and ectasia. For more than 10 years, crosslinking has been a therapeutic option in cases of progression. Using riboflavin and UVA-radiation, the anterior corneal stroma (300 µm) gets stiffened by crosslinking of collagen fibers. When protocols and limitations are adhered, the procedure is described to be effective and of low-risk. This review gives an overview about physiologic and pathologic changes in keratoconic corneas before and after crosslinking. Based on histopathologic examination, the current knowledge in published literature is reviewed and is complemented by our own investigations. Georg Thieme Verlag KG Stuttgart · New York.

  18. Corneal Chromoblastomycosis Caused by Fonsecaea pedrosoi

    Directory of Open Access Journals (Sweden)

    Winai Chaidaroon


    Full Text Available Purpose: To report 2 unusual cases of fungal keratitis due to Fonsecaea pedrosoi. Methods: Two patients were diagnosed with Fonsecaea pedrosoi keratitis. Their files were reviewed for predisposing factors, clinical characteristics, microbiological study, treatment, and outcome. Results: Two consecutive patients presented with brownish pigmented corneal ulcers in their eyes after sustaining eye trauma from vegetative matter. In both cases, corneal scrapings were collected for microscopic examination and culture. Dematiaceous hyphae were seen on the smears, and dark pigmented colonies grew on the culture media, identified as F. pedrosoi. Both patients were treated and cured with combined topical antifungal agents and oral itraconazole. The first patient required an amniotic membrane patch, while the second received an intracameral amphotericin B injection. Conclusions: Pigmented infiltrates can be an important diagnostic clue, but a microscopic evaluation and culture are required to obtain an accurate diagnosis of Fonsecaea keratitis. The prompt diagnosis and combined antifungal treatment can prevent morbidity associated with this fungal infection.

  19. Corneal biomechanics in asymmetrical normal-tension glaucoma

    Directory of Open Access Journals (Sweden)

    Helmy H


    Full Text Available Hazem Helmy,1 Mahmoud Leila,2 Ahmed Atef Zaki3 1Department of Glaucoma and Optic Nerve Diseases, 2Retina Department, 3Corneal Diseases Department, Research Institute of Ophthalmology, Cairo, Egypt Purpose: We aimed to assess corneal biomechanics using the ocular response analyzer in patients with normal-tension glaucoma (NTG, and to evaluate the relationship between corneal biomechanics and visual field loss. Methods: This was a prospective observational case series including patients with bilateral asymmetric NTG. For all patients, corneal hysteresis (CH, corneal resistance factor (CRF, CH - CRF difference, and central corneal thickness values were matched against the mean deviation (MD of the visual field and the cup/disc ratio. For paired-eye comparison in each patient, both eyes were categorized into a better-eyes group and a worse-eyes group according to lower and higher corneal-compensated intraocular pressure readings, respectively. Statistical analysis was carried out with the independent-samples Student’s t-test, and the level of statistical significance was set at 0.05. Correlation was assessed using Pearson’s correlation coefficient. Results: The study included 240 eyes of 120 patients. CH was inversely proportional to the MD in the visual field (P=0.01. CRF in both eyes was inversely proportional to the MD of the visual field (P=0.01. CH - CRF difference was directly proportional to the MD of the visual field (P=0.01. For paired-eye comparison, lower corneal-compensated intraocular pressure was associated with higher CH, higher CRF, smaller cup/disc ratio, and less deterioration of MD of visual field. Conclusion: CH, CRF, and CH - CRF are more powerful predictors of NTG progression than central corneal thickness. Keywords: corneal-compensated intraocular pressure, corneal hysteresis, corneal resistance factor

  20. Long-term results of MyoRing treatment of keratoconus. (United States)

    Daxer, Albert; Ettl, Armin; Hörantner, Robert

    To study long-term results of MyoRing treatment of keratoconus. Retrospective study of MyoRing implantation into a corneal pocket for keratoconus. Corneal thickness at the thinnest point remained unchanged, SIM K's, manifest sphere and cylinder were significantly improved at the first follow-up 9 months postoperatively and remained stable until the last follow-up about 5 years after surgery. Uncorrected and corrected distance visual acuity (UDVA, CDVA) were significantly improved at the first follow-up 9 months postoperatively and were further ameliorated until the last follow-up about 5 years after surgery. The treatment was safe and effective with continuing improvement of visual acuity during the 5 years after surgery. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

  1. The ring laser gyro (United States)

    Chow, W. W.; Gea-Banacloche, J.; Pedrotti, L. M.; Sanders, V. E.; Schleich, W.; Scully, M. O.


    This paper presents a review of both active and passive ring laser devices. The operating principles of the ring laser are developed and discussed, with special emphasis given to the problems associated with the achievement of greater sensitivity and stability. First-principle treatments of the nature of quantum noise in the ring laser gyro and various methods designed to avoid low-rotation-rate lock-in are presented. Descriptions of state-of-the-art devices and current and proposed applications (including a proposed test of metric theories of gravity using a passive cavity ring laser) are given.


    Directory of Open Access Journals (Sweden)

    S. V. Trufanov


    Full Text Available Recurrent corneal erosion (RCE syndrome is characterized by episodes of recurrent spontaneous epithelial defects. Main clinical symptoms (pain, redness, photophobia, lacrimation occurred at night. Corneal lesions revealed by slit lamp exam vary depending on the presence of corneal epithelium raise, epithelial microcysts or epithelial erosions, stromal infiltrates and opacities. Microtraumas, anterior corneal dystrophies, and herpesvirus give rise to RCE. Other causes or factors which increase the risk of RCE syndrome include meibomian gland dysfunction, keratoconjunctivitis sicca, diabetes, and post-LASIK conditions. Basal membrane abnormalities and instability of epithelial adhesion to stroma play a key role in RCE pathogenesis. Ultrastructural changes in RCE include abnormalities of basal epithelial cells and epithelial basal membrane, absence or deficiency of semi-desmosomes, loss of anchor fibrils. Increase in matrix metalloproteinases and collagenases which contribute to basal membrane destruction results in recurrent erosions and further development of abnormal basal membrane. The goals of RCE therapy are to reduce pain (in acute stage, to stimulate re-epithelization, and to restore «adhesion complex» of basal membrane. In most cases, RCE responds to simple conservative treatment that includes lubricants, healing agents, and eye patches. RCEs that are resistant to simple treatment, require complex approach. Non-invasive methods include long-term contact lens use, instillations of autologous serum (eye drops, injections of botulinum toxin (induces ptosis, antiviral agent use or oral intake of metalloproteinase inhibitors. Cell membrane stabilizers, i.e., antioxidants, should be included into treatment approaches as well. Antioxidant effect of Emoxipine promotes tissue reparation due to the prevention of cell membrane lipid peroxidation as well as due to its anti-hypoxic, angioprotective, and antiplatelet effects. If conservative therapy

  3. Decreased central corneal thickness in ankylosing spondylitis. (United States)

    Ortak, Huseyin; Inanır, Ahmet; Demir, Selim; Uysal, Alper; Şahin, Şafak; Sağcan, Mustafa; Önder, Yalçın; Alim, Sait; Demir, Ayşe Kevser


    Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 μm, range 462-600 μm, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 μm, range 510-620 μm, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p ankylosing spondylitis. In addition, attention must be given to lower dry eye tests in surgical interventions such as photorefractive keratectomy and laser in situ keratomileusis in ankylosing spondylitis patients.

  4. Study on phototherapeutic keratotomy for bacterial corneal lesions in rabbit

    Directory of Open Access Journals (Sweden)

    Xin Zhou


    Full Text Available AIM: To study the effect of phototherapeutic keratectomy(PTKon rabbit bacterial corneal ulcer model and explore the clinical potential of this method. METHODS: Totally 48 eyes from all the 24 New Zealand rabbits were inoculated with Staphylococcus aureus and bacterial corneal ulcer model was established successfully. At 1d after inoculation, 48 eyes were given levofloxacin eye drops when corneal ulcer was confirmed. Then slit lamp inspection and optical coherence tomography(OCTwere performed to measure the central corneal ulcer depth. All the rabbits right eyes were treated with PTK, as an observation group, left eyes were not treated as a control group. The eye section were observed by slit lamp and central thickness of corneal ulcer was measured by OCT at 3 and 7d after this operation. Rabbits were sacrificed and the cornea was removed for pathological section 7d later. RESULTS: The corneal ulcers in both groups had a tendency to heal, showing a decrease in ulcer area and smoothness of the surface. There was no significant difference in the depth of corneal ulcer between the observation group and the control group before PTK(t=0.706, P=0.484. The difference between the two groups of eyes at 3 and 7d after PTK was obviously(PCONCLUSION: PTK can effectively cure rabbit Staphylococcus aureus corneal ulcer and promote ulcer wound healing, which may be used for clinical treatment of patients with bacterial corneal lesions.

  5. Corneal optics after reading, microscopy and computer work. (United States)

    Collins, Michael J; Buehren, Tobias; Bece, Andrej; Voetz, Stephanie C


    To compare lid-induced changes in corneal optics following reading, microscopy and computer work. Nine subjects with normal ocular health were recruited for the study. Five subjects were myopic, two were emmetropic, one was astigmatic and one was hyperopic. Corneal topography was measured before and after 60 mins of reading a novel, performing a blood cell counting task on a microscope and Internet searching. Corneal topography data were used to derive the corneal wavefront Zernike coefficients up to the fourth order. A meridian analysis of instantaneous corneal power along the upper 90-degree semi-meridian was performed to examine local changes caused by eyelid pressure. Digital photography was used to capture body posture and eyelid position during the tasks. Each of the three tasks showed systematically different effects on both the characteristics and location of corneal topography changes. Reading and microscopy generally exhibited larger and more centrally located changes compared with the computer task. Differences in wavefront aberration characteristics between the three tasks were apparent in both lower and higher order aberrations. The location of corneal distortions differed significantly between microscopy and computer work, with microscopy causing distortions to occur closer to the videokeratoscope measurement axis compared with computer work (p = 0.015). Reading, microscopy and computer work have different effects on corneal aberrations. The results are in agreement with the hypothesis that lid-induced corneal aberrations may play a role in myopia development.

  6. Corneal Tomographic Changes After UV Cross-Linking for Corneal Ectasia (1-Year Results). (United States)

    Baksoellah, Zainab; Lavy, Itay; Baydoun, Lamis; Hooijmaijers, Hilde C M; van Dijk, Korine; Melles, Gerrit R J


    To evaluate changes in maximum keratometry (Kmax), corneal higher-order aberrations (HOAs), and densitometry (backscattered light) up to 1 year after UV cross-linking and their possible relation with changes in the visual outcome. Retrospective cohort study on 18 eyes of 16 patients, who underwent UV cross-linking after the Dresden protocol for progressive keratoconus or ectasia after laser-assisted in situ keratomileusis. Corrected distance visual acuity (CDVA), Scheimpflug-based corneal tomography, mean image brightness (corneal densitometry) from the anterior 120 μm of the midcornea, and posterior 60 μm of the central 6 mm of the cornea, and HOAs were evaluated. Kmax at 1 month (59.7 ± 6.0D) after UV cross-linking resembled preoperative Kmax (59.3 ± 6.4D, P = 0.368), decreased until 3 months postoperatively (58.3 ± 6.3D, P = 0.002), and stabilized thereafter (P > 0.227). All postoperative corneal densitometry values were higher than preoperative values in all measured depths (P corneal HOAs (4.28 ± 1.64 μm and 3.87 ± 1.62 μm, respectively) resembled preoperative values (4.10 ± 1.70 μm and 3.67 ± 1.62 μm, respectively; P > 0.221) and then decreased until 12 months postoperatively (3.86 ± 1.84 μm and 3.40 ± 1.80 μm, respectively; P 0.345 and P > 0.257, respectively). No relations were found between CDVA and the evaluated parameters (P > 0.05). One year after UV cross-linking, the observation of stable CDVA and thinnest point thickness, together with reduced Kmax suggests no ectasia progression within the study period in these cases. Although HOAs showed a trend toward improvement, corneal densitometry remained elevated.

  7. Effects of single-segment Intacs implantation on visual acuity and corneal topographic indices of keratoconus

    Directory of Open Access Journals (Sweden)

    Kazem Amanzadeh


    Conclusion: Intacs implantation in keratoconic eyes increased visual acuity and made corneal shape less irregular. However, the improvements of visual acuity and corneal shape were not strongly correlated.

  8. Manifestaciones corneales en las enfermedades sistémicas Corneal manifestations in systemic diseases


    J. Zarranz-Ventura; E. De Nova; J. Moreno-Montañés


    Un gran número de enfermedades sistémicas presentan manifestaciones corneales dentro de su espectro de enfermedad. El estudio detallado de todos los cuadros que asocian patología corneal resulta inabarcable, por ello se presentan las enfermedades más prevalentes o características. Este estudio contempla las enfermedades pulmonares y conectivopatías (colagenosis, enfermedades reumatológicas y enfermedades inflamatorias idiopáticas), las enfermedades dermatológicas, cardiovasculares, hematológi...

  9. Corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis

    Directory of Open Access Journals (Sweden)

    Li-Dong Yang


    Full Text Available AIM: To investigate the clinical effect of corneal layer plate removal with Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis.METHODS: There were 168 cases suffered keratomycosis that the focus located shallow of the cornea and was not obvious to drug, who registered in our hospital from March 2005 to June 2010. In surgery we removed plate layer to cormea clear, the region was greater than focus for 0.5mm,then we injected fluconazole which is 2g/L density in corneal stroma to make the edema area greater than Removal of area for 0.5mm. At last we took pedicle conjunctival flap to cover the plant bed by continuous suture. Postoperative day use drug to drop eye and to observe that whether recurrent of the keratomycosis and how was the edema degrade, the blood supply of conjunctival graft pieces, how about the stimulating signs of the surgery eye, the vision.RESULTS: The improvement rate was 96.2% after surgery for seven days and the cure rate was 95.5% after surgery for one months. We found in 157 eyes accepted trigeminy surgery there were 6 eyes recurrence and the recurrence rate was 3.8%. The mean time of corneal stromal edema faded away was 13.4 hours. After surgery for one month there were 39 eyes(24.8%whose vision removed than preoperative, there were 91 eyes(58.0%whose vision were same as preoperative and there were 27 eyes(17.2%whose vision lower than preoperative. In these operations the loss ratio of corneal endothelium was from 0%-8%, the mean was 2.9%. The irritative symptoms postoperative were mild for 87%, moderate for 10% and severe for 3%. By this surgery the mean length of stay was 7.3 days so the mean hospitalization expenses only were 2160 RMB. Three months after surgery, 4 cases were slight corneal ectasia.CONCLUSION: This operation combined corneal layer plate removal, Fluconazole injected corneal stroma and autologous conjunctival transplantation for keratomycosis which was in

  10. EBT ring physics

    International Nuclear Information System (INIS)

    Uckan, N.A.


    This workshop attempted to evaluate the status of the current experimental and theoretical understanding of hot electron ring properties. The dominant physical processes that influence ring formation, scaling, and their optimal behavior are also studied. Separate abstracts were prepared for each of the 27 included papers

  11. Children of Sex Rings. (United States)

    Hunt, Patricia; Baird, Margaret


    Outlines three major differentiating categories of children who were sexually abused by sex rings: level of fear, ability to trust, and disclosure confusion. Addresses denial and resistance regarding child sexual exploitation by a ring among practitioners in the child welfare system. (Author/BB)

  12. Illustration of Saturn's Rings (United States)


    This illustration shows a close-up of Saturn's rings. These rings are thought to have formed from material that was unable to form into a Moon because of tidal forces from Saturn, or from a Moon that was broken up by Saturn's tidal forces.

  13. Relativistic ring models

    Energy Technology Data Exchange (ETDEWEB)

    Ujevic, Maximiliano [Universidade Federal do ABC (UFABC), Santo Andre, SP (Brazil). Centro de Ciencias Naturais e Humanas; Letelier, Patricio S.; Vogt, Daniel [Universidade Estadual de Campinas (UNICAMP), SP (Brazil). Inst. de Matematica, Estatistica e Computacao Cientifica. Dept. de Matematica Aplicada


    Full text: Relativistic thick ring models are constructed using previously found analytical Newtonian potential-density pairs for flat rings and toroidal structures obtained from Kuzmin-Toomre family of discs. This was achieved by inflating previously constructed Newtonian ring potentials using the transformation |z|{yields}{radical}z{sup 2} + b{sup 2}, and then finding their relativistic analog. The models presented have infinite extension but the physical quantities decays very fast with the distance, and in principle, one could make a cut-off radius to consider it finite. In particular, we present systems with one ring, two rings and a disc with a ring. Also, the circular velocity of a test particle and its stability when performing circular orbits are presented in all these models. Using the Rayleigh criterion of stability of a fluid at rest in a gravitational field, we find that the different systems studied present a region of non-stability that appears in the intersection of the disc and the ring, and between the rings when they become thinner. (author)

  14. Central and Peripheral Corneal Power Change in Myopic Orthokeratology and Its Relationship With 2-Year Axial Length Change. (United States)

    Zhong, Yuanyuan; Chen, Zhi; Xue, Feng; Miao, Huamao; Zhou, Xingtao


    We assessed the relationship between axial length (AL) change and corneal refractive power change induced by orthokeratology (ortho-k) contact lens wear. A total of 88 myopic children aged 7 to 12 years were fitted with ortho-k lenses for overnight wear. Axial length was measured before enrollment and every 6 months after initiation of lens wear up to 24 months. Corneal apical refractive power and the mean power of each concentric ring from 0.5 to 7.2 mm in diameter at 0.1-mm intervals were measured using the Pentacam HR, and compared before and after 3 months of ortho-k lens wear. Summed corneal power change (SCPC) was defined as the sum of relative corneal power change within the central 7.2-mm diameter corneal region. Age, baseline spherical equivalent refractive error (SERE), and SCPC were tested against 2-year AL growth in a stepwise multiple linear regression model. Of the 88 myopic children who were successfully fitted with ortho-k lenses, 64 completed the 2-year follow-up period. These completed test subjects experienced a mean axial growth of 0.37 ± 0.27 mm. Spherical equivalent refractive error and corneal apical refractive power decreased from baseline values of -2.88 ± 0.96 diopters (D) and 43.47 ± 1.03 D to -0.20 ± 0.85 D and 40.61 ± 1.23 D, respectively, after 3 months of lens wear. The mean SCPC was 10.84 ± 5.28 D · mm after 3 months. Axial elongation was significantly correlated with SCPC (standardized β = -0.573, P SCPC and baseline age to predict axial elongation was acceptable (adjusted R2 = 0.56) and statistically significant (F2,61 = 41.09, P < 0.001). Axial elongation in children undergoing ortho-k therapy is negatively correlated with the age of the wearer and summed corneal power change from the central to the mid-peripheral cornea. We speculate that axial elongation is influenced by the extent to which the retinal defocus profile is altered with ortho-k lens wear. ( number, ChiCTR-TNRC-11001210.).

  15. Imaging rings in ring imaging Cherenkov counters

    Energy Technology Data Exchange (ETDEWEB)

    Ratcliff, Blair N


    The general concepts used to form images in Ring Imaging Cherenkov (RICH) counters are described and their performance properties compared. Particular attention is paid to issues associated with imaging in the time dimension, especially in Detectors of Internally Reflected Cherenkov light (DIRCs).

  16. Rings and their modules

    CERN Document Server

    Bland, Paul E


    This book is an introduction to the theory of rings and modules that goes beyond what one normally obtains in a graduate course in abstract algebra. In addition to the presentation of standard topics in ring and module theory, it also covers category theory, homological algebra and even more specialized topics like injective envelopes and projective covers, reflexive modules and quasi-Frobenius rings, and graded rings and modules. The book is a self-contained volume written in a very systematic style: allproofs are clear and easy for the reader to understand and allarguments are based onmaterials contained in the book. A problem sets follow each section. It is suitable for graduate and PhD students who have chosen ring theory for their research subject.

  17. Toxic corneal ulcer: a frequent and sight-threatening disease. (United States)

    Sacchetti, Marta; Lambiase, Alessandro; Coassin, Marco; Bonini, Sergio; Bonini, Stefano


    Overtreatment with topical ophthalmic preparations can lead to toxic corneal ulcer development. This study aimed to investigate the clinical and visual impact of toxic corneal ulcers and the management and risk factors for their development and outcomes. Clinical records of 226 consecutive patients with corneal ulcers referred to our tertiary care center were retrospectively evaluated. Frequency, clinical features, and management of toxic corneal ulcers are described. The relationship between clinical severity and outcomes (healing time, corneal transparency, and visual acuity) of toxic corneal ulcers and the number and classes of topical drugs, the number of daily instillations, and the duration of treatment were statistically evaluated. Toxic corneal ulcer was diagnosed in 9% (21/226) of all patients. After topical treatment discontinuation, the cornea spontaneously healed in all patients in 2 to 21 days. A longer healing time was related to a greater number of topical drugs used (p=0.029), a greater frequency of daily instillations (p=0.042), and a longer duration of treatment (p=0.048). The specific drugs used did not significantly influence healing time. After resolution, 16 out of 21 patients showed corneal scarring and impairment of visual function. The severity of corneal haze was related to the number of drugs used (p=0.023), to the frequency of daily instillations (p=0.031), and to the healing time (p=0.008). Toxic corneal ulcer is a frequent disease that can potentially lead to permanent visual impairment. A high-dose regimen is the major risk factor for corneal toxic ulcer development and poor visual outcomes.

  18. Customized toric intraocular lens implantation for correction of extreme corneal astigmatism due to corneal scarring

    Directory of Open Access Journals (Sweden)

    R Bassily


    Full Text Available R Bassily, J LuckOphthalmology Department, Royal United Hospital, Combe Park, Bath, UKAbstract: A 76-year-old woman presented with decreased visual function due to cataract formation. Twenty-five years prior she developed right sided corneal ulceration that left her with 10.8 diopters (D of irregular astigmatism at 71.8° (steep axis. Her uncorrected visual acuity was 6/24 and could only ever wear a balanced lens due to the high cylindrical error. Cataract surgery was planned with a custom designed toric intraocular lens (IOL with +16.0 D sphere inserted via a wound at the steep axis of corneal astigmatism. Postoperative refraction was -0.75/+1.50 × 177° with a visual acuity of 6/9 that has remained unchanged at six-week follow-up with no IOL rotation. This case demonstrates the value of high power toric IOLs for the correction of pathological corneal astigmatism.Keywords: intraocular lens, corneal ulceration, visual acuity, scarring

  19. Corneal Ectasia After LASIK Combined With Prophylactic Corneal Cross-linking. (United States)

    Taneri, Suphi; Kiessler, Saskia; Rost, Anika; Dick, H Burkhard


    To report a case of unilateral corneal ectasia following LASIK surgery combined with prophylactic corneal cross-linking (CXL) in a young patient. Case report. Preoperative topography was unremarkable in both eyes with a minimum corneal thickness of 554 μm in the right eye and 546 μm in the left eye. Preoperative corrected distance visual acuity (CDVA) was 1.0 (20/20 Snellen) in both eyes with a refraction of +1.25 -2.75 × 10 in the right eye and +0.50 -2.00 × 163 in the left eye. LASIK combined with CXL was uneventful. After 12 months, postoperative topography was unremarkable with an uncorrected distance visual acuity (UDVA) of 1.0 in both eyes. Two years after surgery, the patient presented with a loss of vision (UDVA 0.25) and an inferior steepening on topography in the left eye. Standard CXL was performed to arrest further progression. This report illustrates that the currently used prophylactic CXL protocol in combination with LASIK may not be effectively preventing corneal ectasia in every case. [J Refract Surg. 2017;33(1):50-52.]. Copyright 2017, SLACK Incorporated.

  20. In Vivo Corneal Biomechanical Properties with Corneal Visualization Scheimpflug Technology in Chinese Population

    Directory of Open Access Journals (Sweden)

    Ying Wu


    Full Text Available Purpose. To determine the repeatability of recalculated corneal visualization Scheimpflug technology (CorVis ST parameters and to study the variation of biomechanical properties and their association with demographic and ocular characteristics. Methods. A total of 783 healthy subjects were included in this study. Comprehensive ophthalmological examinations were conducted. The repeatability of the recalculated biomechanical parameters with 90 subjects was assessed by the coefficient of variation (CV and intraclass correlation coefficient (ICC. Univariate and multivariate linear regression models were used to identify demographic and ocular factors. Results. The repeatability of the central corneal thickness (CCT, deformation amplitude (DA, and first/second applanation time (A1/A2-time exhibited excellent repeatability (CV% ≤ 3.312% and ICC ≥ 0.929 for all measurements. The velocity in/out (Vin/out, highest concavity- (HC- radius, peak distance (PD, and DA showed a normal distribution. Univariate linear regression showed a statistically significant correlation between Vin, Vout, DA, PD, and HC-radius and IOP, CCT, and corneal volume, respectively. Multivariate analysis showed that IOP and CCT were negatively correlated with Vin, DA, and PD, while there was a positive correlation between Vout and HC-radius. Conclusion. The ICCs of the recalculated parameters, CCT, DA, A1-time, and A2-time, exhibited excellent repeatability. IOP, CCT, and corneal volume significantly influenced the biomechanical properties of the eye.

  1. Genomics of corneal wound healing: a review of the literature. (United States)

    Maycock, Nick J R; Marshall, John


    Corneal wound healing is a complex process: its mechanisms and the underlying genetic control are not fully understood. It involves the integrated actions of multiple growth factors, cytokines and proteases produced by epithelial cells, stromal keratocytes, inflammatory cells and lacrimal gland cells. Following an epithelial insult, multiple cytokines are released triggering a cascade of events that leads to repair the epithelial defect and remodelling of the stroma to minimize the loss of transparency and function. In this review, we examine the literature surrounding the genomics of corneal wound healing with respect to the following topics: epithelial and stromal wound healing (including inhibition); corneal neovascularisation; the role of corneal nerves in wound healing; the endothelium; the role of aquaporins and aptamers. We also examine the effect of ectasia on corneal wound healing with regard to keratoconus and following corneal surgery. A better understanding of the cellular and molecular changes that occur during repair of corneal wounds will provide the opportunity to design treatments that selectively modulate key phases of the healing process resulting in scars that more closely resemble normal corneal architecture. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  2. Effects of genipin corneal crosslinking in rabbit corneas. (United States)

    Avila, Marcel Y; Narvaez, Mauricio; Castañeda, Juan P


    To evaluate the effect of genipin, a natural crosslinking agent, in rabbit eyes. Department of Ophthalmology, Universidad Nacional de Colombia Centro de Tecnologia Oftalmica, Bogotá, Colombia. Experimental study. Ex vivo rabbit eyes (16; 8 rabbits) were treated with genipin 1.00%, 0.50%, and 0.25% for 5 minutes with a vacuum device to increase corneal permeability. Penetration was evaluated using Scheimpflug pachymetry (Pentacam). In the in vivo model (20 rabbits; 1 eye treated, 1 eye with vehicle), corneas were crosslinked with genipin as described. Corneal curvature, corneal pachymetry, and intraocular pressure (IOP) assessments as well as slitlamp examinations were performed 0, 7, 30, and 60 days after treatment. In the ex vivo model, Scheimpflug pachymetry showed deep penetration in the rabbit corneas with an increase in corneal density and a dose-dependent relationship. Corneal flattening was observed in treated eyes (mean 4.4 diopters ± 0.5 [SD]) compared with the control eyes. Pachymetry and IOP were stable in all evaluations. No eye showed toxicity in the anterior chamber or in the lens. Corneal crosslinking induced by genipin produced significant flattening of the cornea with no toxicity in rabbit eyes. This crosslinking could be useful in the treatment of corneal ectasia and in the modification of corneal curvature. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. Complications Following Corneal Cross-Linking Treatment in Keratectasia

    Directory of Open Access Journals (Sweden)

    Faik Oruçoğlu


    Full Text Available Pur po se: To report complications of corneal cross-linking treatment in keratoconus and secondary ectatic eyes. Ma te ri al and Met hod: Cases that were treated between February 2007 and February 2011, had a minimum follow-up of one month, and developed complications following corneal cross-linking were retrospectively evaluated. Re sults: Complication data were present in eight cases. Scar formation developed in three cases. Scar density has decreased in one patient during long-term follow-up. Keratometric flattening was observed associated with scar development. Cross-linking was performed on the second eye of the affected patient, and no scar development was observed. Corneal clouding was observed in one patient three days after treatment. Corneal clouding has decreased in the following days. Local corneal edema has developed in one patient, and improvement was achieved in the following days. Uveitis has developed in one case with total improvement after adding topical steroids. Post-LASIK ectasia eye showed deep lamellar keratitis after cross-linking. In one patient, epithelization was completed in 14 days. Dis cus si on: Corneal scars, corneal clouding and edema, uveitis, and late epithelization are possible complications after corneal cross-linking. Scar density was decreased, while other complications showed total improvement. (Turk J Ophthalmol 2013; 43: 1-6

  4. Corneal Biomechanical Changes and Tissue Remodeling After SMILE and LASIK. (United States)

    Shetty, Rohit; Francis, Mathew; Shroff, Rushad; Pahuja, Natasha; Khamar, Pooja; Girrish, Molleti; Nuijts, Rudy M M A; Sinha Roy, Abhijit


    To evaluate transient corneal tissue healing and biomechanical changes between laser in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) eyes. In each patient, one eye underwent LASIK and the other underwent SMILE. Optical coherence tomography (OCT) and dynamic Scheimpflug imaging (Corvis-ST) was used to assess tissue healing and biomechanics, respectively. Analyses of OCT scans yielded corneal speckle distribution (CSD) and Bowman's roughness index (BRI). Waveform analyses of deformation amplitude yielded corneal stiffness. Further, corneal force versus corneal deformation data helped compare the two procedures. BRI increased and then decreased transiently after both treatments (P < 0.05). However, SMILE eyes had BRI similar to that of their preoperative state compared to LASIK eyes at 6-month follow-up. CSD indicated a marked increase in the number of bright pixels and a decrease in the number of dark pixels after SMILE (1-month follow-up) and LASIK eyes (3-month follow-up), respectively. CSD returned to near preoperative state thereafter, respectively. Corneal stiffness change from preoperative state was similar between LASIK and SMILE eyes. However, deformation at discrete values of corneal force indicated some recovery of biomechanical strength after SMILE, but not in LASIK eyes. BRI and CSD indicated earlier tissue healing in SMILE eyes than in LASIK. CSD results may indicate delayed cell death in LASIK eyes and increased light scatter due to interface fluid in SMILE eyes. Corneal biomechanical strength remodeled better in SMILE. This may indicate some hydration-related recovery.

  5. Crosslinking and corneal cryotherapy in acanthamoeba keratitis -- a histological study. (United States)

    Hager, Tobias; Hasenfus, A; Stachon, T; Seitz, B; Szentmáry, N


    Acanthamoeba keratitis is rare, but difficult to treat. Penetrating keratoplasty is performed in therapy-resistant cases. Nevertheless, subsequent recurrences occur in 40 % of the cases. In addition to triple-topical therapy (polyhexamid, propamidinisoethionat, neomycin), treatment alternatives are corneal cryotherapy and/or crosslinking (CXL). The aim of our present histological study was to analyze the persistence of acanthamoebatrophozoites and cysts, the persistence of bacteria, and activation of keratocytes in corneas of acanthamoeba keratitis patients following corneal cryotherapy and/or CXL. We analyzed histologically corneal buttons (from penetrating keratoplasties) of nine patients with acanthamoeba keratitis, following corneal cryotherapy (two patients) or a combination of crosslinking and corneal cryotherapy (seven patients), using haematoxilin–eosin, periodic acid Schiff (PAS), Gram and alpha-smooth muscle actin (alpha-SMA) stainings. Acanthamoeba trophozoites persisted in three corneas after cryotherapy and CXL. Cysts persisted in one of two corneas following corneal cryotherapy and in six of seven corneas after a combination of CXL and cryotherapy. One cornea showed positive Gram staining, but there were no alpha-SMA positive keratocytes in any of the corneas. Crosslinking and corneal cryotherapy have only limited impact on killing of acanthamoeba trophozoites, cysts, or bacteria. Corneal cryotherapy and CXL did not stimulate myofibroblastic transformation of keratocytes.

  6. Minimising Corneal Scarring from the use of Harmful Traditional Eye ...

    African Journals Online (AJOL)

    Corneal scarring is the fourth largest cause of blindness globally, and a much more prominent factor in developing countries. Blindness from corneal scarring is largely a preventable phenomenon, and is capable of causing significant morbidity that can last for a lifetime. A significant proportion of these cases are caused by ...

  7. Changes of Corneal Optical Properties after UVB Irradiation Investigated Spectrophotometrically

    Czech Academy of Sciences Publication Activity Database

    Čejka, Čestmír; Pláteník, J.; Širc, Jakub; Ardan, Taras; Michálek, Jiří; Brůnová, B.; Čejková, Jitka


    Roč. 59, č. 4 (2010), s. 591-597 ISSN 0862-8408 Grant - others:GA MŠk(CZ) 1M0538 Program:1M Institutional research plan: CEZ:AV0Z50390512; CEZ:AV0Z40500505 Keywords : corneal hydration * corneal light absorption * absorption coefficients Subject RIV: FF - HEENT, Dentistry Impact factor: 1.646, year: 2010

  8. Corneal reshaping and wavefront aberrations during overnight orthokeratology. (United States)

    Lian, Yan; Shen, Meixiao; Huang, Shenghai; Yuan, Yimin; Wang, Yaozeng; Zhu, Dexi; Jiang, Jun; Mao, Xinjie; Wang, Jianhua; Lu, Fan


    To investigate changes of corneal thickness at the vertical and horizontal meridians and of wavefront aberrations (WA) over a 30-day period of overnight myopia orthokeratology (OK) lens wear. Sixteen subjects (11 women, 5 men, 26.3±3.2 years) were enrolled and fitted for OK lenses. Long scan depth optical coherence tomography was used to measure corneal thickness profiles at both horizontal and vertical meridians at baseline and on days 1, 7, and 30 days. Corneal and ocular WA of a 6-mm pupil were measured and the root-mean-square (RMS) of the astigmatism, coma, spherical aberration (SA), and total higher-order aberrations (HOAs) were determined. During the 30-day period, the central cornea thinned in the horizontal and vertical meridians, whereas corneal thickening occurred in the temporal, nasal, and inferior mid-peripheries. In contrast, the cornea thinned in the mid-peripheral superior. There were significant increases in RMS for astigmatism, SA, coma, and positive horizontal coma during the study period. After OK, there were significant positive correlations between the midperipheral-central thickness change difference and the changes in corneal and ocular RMS of total HOAs and SA (r range: 0.281 to 0.492, POK caused unique changes in corneal thickness profiles at the vertical and horizontal meridians and increased corneal and ocular HOAs related to corneal reshaping.

  9. Prevalence of corneal ulcer among contact lens wearers in Nigeria ...

    African Journals Online (AJOL)

    Corneal Ulceration has been described as the most serious complication of contact lens wear worldwide. The incidence of corneal ulceration in contact lens wearers in Nigeria was determined retrospectively. 1759 case notes of patients who had worn contact lenses for at least one year were obtained from eye clinics in ...

  10. Matrix Regeneration Therapy: A Case Series of Corneal Neurotrophic Ulcers. (United States)

    Arvola, Riku P J; Robciuc, Alexandra; Holopainen, Juha M


    Treating corneal neurotrophic ulcers is challenging. Topical application of matrix regeneration therapy (RGTA), which is a dextran derivative polymer and heparan sulfate analog, is a promising regenerative therapy and an alternative or additional therapeutic regimen when corneal healing is compromised. The aim of this study was to evaluate the efficacy of RGTA (Cacicol) in the treatment of 6 patients with severe neurotrophic ulcers. We present an uncontrolled prospective case series of 6 patients (6 eyes) with severe corneal neurotrophic ulcers. Patients were treated with topical RGTA at a dose of 1 drop every second day. The main outcome measure was complete corneal epithelialization. We measured corneal thickness by anterior segment swept-source optical coherence tomography. Two patients (33%) showed complete corneal healing, one at 6 weeks and the other at 10 weeks. Treatment was considered failure in 4 patients (67%), and 1 patient had corneal perforation. None of the patients showed improvement in best-corrected visual acuity. There were no RGTA-related local or systemic side effects. Based on previous studies, RGTA seems to be a promising therapeutic agent for controlling ocular surface inflammation and promoting corneal healing. In this study, the efficacy of RGTA did not match the encouraging results from previous reports.

  11. Case Report: Corneal Pyogenic Granuloma: Rare Complication of ...

    African Journals Online (AJOL)

    Slit lamp examination showed vascularized central corneal mass with surrounding stromal infiltrates. The mass was excised, and histopathological examination confirmed pyogenic granuloma of the cornea. Conclusion: Corneal pyogenic granuloma could be a rare complication of infectious keratitis. Therefore, it should be ...

  12. Distributed scanning volumetric SDOCT for motion corrected corneal biometry. (United States)

    McNabb, Ryan P; Larocca, Francesco; Farsiu, Sina; Kuo, Anthony N; Izatt, Joseph A


    We present a method, termed distributed scanning OCT (DSOCT), which reduces the effects of patient motion on corneal biometry utilizing current-generation clinically available spectral domain optical coherence tomography (SDOCT) systems. We first performed a pilot study of the power spectrum of normal patient axial eye motion based on repeated (M-mode) SDOCT. Using DSOCT to reduce the effects of patient motion, we conducted a preliminary patient study comparing the measured anterior and posterior corneal curvatures and the calculated corneal power to both corneal topography and Scheimpflug photography in normal subjects. The repeatability for the measured radius of curvature of both anterior and posterior surfaces as well as calculated corneal refractive power using DSOCT was comparable to those of both topography and Scheimpflug photography.

  13. Usefulness of corneal esthesiometry for screening diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Lênio Souza Alvarenga


    Full Text Available OBJECTIVE: To assess the usefulness of corneal esthesiometry for screening diabetic retinopathy. METHODS: A cross-sectional study was carried out comprising 575 patients attending a diabetic retinopathy-screening program in the city of São Paulo. Corneal esthesiometry was assessed with the Cochet-Bonnet esthesiometer. The presence of diabetic retinopathy was detected with indirect fundoscopy. The validity of corneal esthesiometry in identifying diabetic retinopathy was evaluated by the Receiver Operating Characteristic (ROC curve. RESULTS: Sensitivity and specificity analyses of the corneal esthesiometry for detecting the stages of diabetic retinopathy using different cut-offs showed values less than 80%. The best indices (72.2% sensitivity and 57.4% specificity were obtained for the identification of patients with proliferative diabetic retinopathy. CONCLUSIONS: In the study series, corneal esthesiometry was not a good indicator of diabetic retinopathy.

  14. Corneal ectasia secondary to LASIK after arcuate keratotomy. (United States)

    Ghanem, Ramon C; Ghanem, Marcielle A; Bogoni, Ayla; Ghanem, Vinícius C


    To present a case of corneal ectasia after LASIK in a patient with previous arcuate keratotomy. Case report. The patient underwent arcuate keratotomy in both eyes in 1997 for with-the-rule regular hyperopic astigmatism and uneventful bilateral LASIK for residual astigmatism 5 years later. Visual acuity and refraction remained stable for 5 years, when the patient noticed worsening visual acuity. Corneal topography showed progressive inferior steepening, confirming the diagnosis of ectasia. Corneal high-resolution optical coherence tomography revealed a normal LASIK flap. The patient had no risk factors for corneal ectasia other than previous incisional surgery. This case suggests that isolated arcuate keratotomy can be a significant risk factor for the development of corneal ectasia after LASIK. Copyright 2013, SLACK Incorporated.

  15. Bioactive self-assembled peptide nanofibers for corneal stroma regeneration. (United States)

    Uzunalli, G; Soran, Z; Erkal, T S; Dagdas, Y S; Dinc, E; Hondur, A M; Bilgihan, K; Aydin, B; Guler, M O; Tekinay, A B


    Defects in the corneal stroma caused by trauma or diseases such as macular corneal dystrophy and keratoconus can be detrimental for vision. Development of therapeutic methods to enhance corneal regeneration is essential for treatment of these defects. This paper describes a bioactive peptide nanofiber scaffold system for corneal tissue regeneration. These nanofibers are formed by self-assembling peptide amphiphile molecules containing laminin and fibronectin inspired sequences. Human corneal keratocyte cells cultured on laminin-mimetic peptide nanofibers retained their characteristic morphology, and their proliferation was enhanced compared with cells cultured on fibronectin-mimetic nanofibers. When these nanofibers were used for damaged rabbit corneas, laminin-mimetic peptide nanofibers increased keratocyte migration and supported stroma regeneration. These results suggest that laminin-mimetic peptide nanofibers provide a promising injectable, synthetic scaffold system for cornea stroma regeneration. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  16. Use of Topical Insulin to Treat Refractory Neurotrophic Corneal Ulcers. (United States)

    Wang, Angeline L; Weinlander, Eric; Metcalf, Brandon M; Barney, Neal P; Gamm, David M; Nehls, Sarah M; Struck, Michael C


    To report the clinical course of 6 patients with refractory neurotrophic corneal ulcers that were treated with topical insulin drops. Retrospective chart review of patients who had neurotrophic corneal ulcers or epithelial defects refractory to standard medical and surgical treatment. Insulin drops, prepared by mixing regular insulin in artificial tears with a polyethylene glycol and propylene glycol base at a concentration of 1 unit per milliliter, were prescribed 2 to 3 times daily. Six patients, aged 2 to 73 years, developed neurotrophic corneal ulcers refractory to a range of medical and surgical treatments, including bandage contact lens, amniotic membrane grafting, and permanent tarsorrhaphy. Each patient was administered topical insulin drops with complete corneal reepithelialization within 7 to 25 days. Topical insulin may be a simple and effective treatment for refractory neurotrophic corneal ulcers. Further study is required to determine the clinical efficacy and side effect profile of insulin drops.

  17. Ring chromosome 13

    DEFF Research Database (Denmark)

    Brandt, C A; Hertz, Jens Michael; Petersen, M B


    A stillborn male child with anencephaly and multiple malformations was found to have the karyotype 46,XY,r(13) (p11q21.1). The breakpoint at 13q21.1, determined by high resolution banding, is the most proximal breakpoint ever reported in patients with ring chromosome 13. In situ hybridisation...... with the probe L1.26 confirmed the derivation from chromosome 13 and DNA polymorphism analysis showed maternal origin of the ring chromosome. Our results, together with a review of previous reports of cases with ring chromosome 13 with identified breakpoints, could neither support the theory of distinct clinical...

  18. Faithfully quadratic rings

    CERN Document Server

    Dickmann, M


    In this monograph the authors extend the classical algebraic theory of quadratic forms over fields to diagonal quadratic forms with invertible entries over broad classes of commutative, unitary rings where -1 is not a sum of squares and 2 is invertible. They accomplish this by: (1) Extending the classical notion of matrix isometry of forms to a suitable notion of T-isometry, where T is a preorder of the given ring, A, or T = A^2. (2) Introducing in this context three axioms expressing simple properties of (value) representation of elements of the ring by quadratic forms, well-known to hold in

  19. Mycotic corneal ulcers in upper Assam

    Directory of Open Access Journals (Sweden)

    Reema Nath


    Full Text Available Purpose : To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. Materials and Methods: In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. Results: In 188 (60.6% cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%. The maximum (23.4% cases were reported during the paddy harvesting season in Assam (January and February. Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH mount. The commonest predisposing factor was corneal injury (74.5%. While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25% was the commonest isolate followed by Aspergillus species (19%, Curvularia species (18.5% and Penicillium species (15.2%. Yeasts were isolated in 2.7% (n=5 cases. Conclusions : Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.

  20. Mycotic corneal ulcers in upper Assam. (United States)

    Nath, Reema; Baruah, Syamanta; Saikia, Lahari; Devi, Bhanu; Borthakur, A K; Mahanta, J


    To study the association of various risk factors and epidemiological variables of mycotic keratitis treated at a tertiary referral hospital of upper Assam. In this hospital-based prospective study a total of 310 consecutive corneal ulcer cases attending the ophthalmology outpatient department of Assam Medical College were enrolled between April 2007 and March 2009. After clinical and slit-lamp biomicroscopic examination in all suspected cases, smears and culture examination for fungus was done to establish the etiology. Demographic information and associated probable risk factors of individual cases were noted in a predesigned questionnaire. In 188 (60.6%) cases fungal etiology could be established. Out of them 67.6% were males. The most commonly affected age group was 41-50 years (25.5%). The maximum (23.4%) cases were reported during the paddy harvesting season in Assam (January and February). Fungal element could be demonstrated in 65.2% cases in direct potassium hydroxide (KOH) mount. The commonest predisposing factor was corneal injury (74.5%). While diabetes was a significant systemic predisposing factor in mixed bacterial and fungal infections in 11.1% cases, blocked naso-lacrimal duct was the local predisposing factor in 11.1% of cases. Fusarium solani (25%) was the commonest isolate followed by Aspergillus species (19%), Curvularia species (18.5%) and Penicillium species (15.2%). Yeasts were isolated in 2.7% (n=5) cases. Ocular trauma was the commonest cause of fungal corneal ulcer in Assam and Fusarium solani was the commonest species responsible for it. Most of the mycotic ulcer cases come from rural areas including the tea gardens.

  1. Corneal surface reconstruction - a short review

    Directory of Open Access Journals (Sweden)

    Madhavan H N


    Full Text Available Cornea is the clear, dome-shaped surface that covers the front of the eye and when damage due to burns or injury and several other diseases, stem cells residing in its rim called "limbus" are stimulated to multiply to support growth of new epithelial cells over its surface. If this ready source of stem cells is damaged or destroyed the natural repair is not possible and such a condition is known as corneal limbal stem cell deficiency (CLSCD disease. Stem cell transplant helps such persons to regenerate the corneal surface. Human corneal limbal stem cell transplantation is at present an established procedure with reasonable good clinical outcome particularly when autologous limbal epithelial tissue from a fellow unaffected eye is used. 1, 2 A major concern related to the autograft is the possibility of CLSCD at the donor site, 3 techniques that allowed the expansion of a small limbal biopsy in the laboratory using cell cultures that could be then transplanted to the affected eye have been developed ,4, 5 Human amniotic membrane (HAM is used as a scaffold for both culturing the human limbal epithelial cells and for ocular surface reconstruction with the cultured limbal epithelial cells. 4-7 However, researchers have used alternative scaffolds like collagen 8, fibrin gel 9 and cross-linked gel of fibronectin and fibrin. 10 All these are biological materials and also need for animal 3T3 feeder layer for stem cell cultures. The properties of HAM are unique including antiadhesive effects, bacteriostatic effects, wound protection, pain reduction, and improvement of epithelialization and characteristically lacking imunogenicity. The use of amniotic membrane transplantation (AMT to treat ocular surface abnormalities was first reported by Graziella Pellegrini, chief of stem cell laboratory at Giovanni Paolo Hospital in Venice, Italy, who was the first to demonstrate the limbal stem cell transplant in 1997. Amniotic membrane has been successfully used in

  2. Finite element modeling of corneal strip extensometry

    CSIR Research Space (South Africa)

    Botha, N


    Full Text Available Donnell, ?Corneal tensile strength in fully healed radial keratotomy wounds.? Investigative Ophthalmology & Visual Science, vol. 35, no. 7, pp. 3022 ?3031, Jun. 1994. [Online]. Available: [12] A. Elsheikh, M. Brown...- timization process, are listed in Table I for two different age groups [12]. Note that the incompressibility parameter, D1, c SACAM 2012 26 is fixed at 0.004, which ensures the incompressibility of the material model. The corresponding extensometry test...

  3. Characteristics of corneal ectasia after LASIK for myopia. (United States)

    Twa, Michael D; Nichols, Jason J; Joslin, Charlotte E; Kollbaum, Pete S; Edrington, Timothy B; Bullimore, Mark A; Mitchell, G Lynn; Cruickshanks, Karen J; Schanzlin, David J


    There are numerous reports of corneal ectasia after laser in situ keratomileusis (LASIK) for myopia without a consistent definition of this condition or a definitive etiology. We conducted a retrospective analysis of published case reports to describe common characteristics of this postoperative event and compared them with findings from a group of successful LASIK patients. A MEDLINE search for "LASIK" and "ectasia" yielded 21 relevant articles published before May 2003 (n = 86 eyes, 59 patients). A comparison group (n = 103 eyes, 63 patients) was selected from a clinic-based sample of successful LASIK patients with 12 months of follow-up after treatment. Descriptive statistics are reported as median and interquartile range. Comparisons were performed using the Wilcoxon rank sum, Wilcoxon signed rank, and chi-square tests. Time to diagnosis of ectasia after LASIK was 13 months (6 to 20 months). Residual myopia in the ectasia group was -3.69 D (-6.00 to -2.13 D) and was significantly greater than the comparison group, -0.38 D (-0.75 to 0.00 D), P ectasia had increased corneal toricity 2.87 D (2.00 to 4.9 D) with increased oblique astigmatism 1.3 D (0.23 to 2.89 D) relative to eyes in the comparison group 0.00 D (0.00 to 0.08 D), and a loss of 2 lines (-0.5 to -6 lines) of best spectacle-corrected visual acuity (all P corneal transplantation. Preoperative characteristics of corneal ectasia include worse visual acuity, less corneal thickness, greater residual myopia, and greater corneal toricity than nonectatic eyes. Treatment factors associated with corneal ectasia after LASIK are greater stromal ablation and less residual stromal bed thickness. Postoperative characteristics of corneal ectasia are myopic refractive error with increased astigmatism, worse spectacle-corrected visual acuity, increased corneal toricity with topographic abnormality, and progressive corneal thinning.

  4. Utilización del bevacizumab en la neovascularización corneal Use of Bevacizumab in corneal neovascularization

    Directory of Open Access Journals (Sweden)

    Taimi Cárdenas Díaz


    Full Text Available La neovascularización corneal es causa de pérdida de su transparencia y también es un factor de riesgo para el rechazo secundario de trasplantes en esa estructura. El bevacizumab es un anticuerpo monoclonal humanizado que bloquea selectivamente la cascada de formación del VEGF y con esto disminuye la formación de vasos sanguíneos. Se presentan tres casos con neovascularización corneal por diferentes causas, a los cuales se le administró tres dosis subconjuntival de 2,5 mg de bevacizumab, con una frecuencia mensual. En los ojos tratados se observó una regresión parcial de la neovascularización corneal y fue más visible en el paciente con antecedente de quemadura corneal.Neovascularization of the cornea is a cause of loss of transparency of the same and is also a risk factor for secondary rejection corneal transplants. Bevacizumab is a humanized monoclonal antibody that selectively blocks the formation of the VEGF cascade and, with this, decreases the formation of blood vessels. Three cases with corneal neovascularization from different causes were presented, which were given three doses of 2.5 mg subconjunctival bevacizumab once a month. A partial regression of corneal neovascularization was observed in the treated eyes, being more visible in the patient with a history of corneal burn.

  5. Fourier analysis algorithm for the posterior corneal keratometric data: clinical usefulness in keratoconus. (United States)

    Sideroudi, Haris; Labiris, Georgios; Georgantzoglou, Kimon; Ntonti, Panagiota; Siganos, Charalambos; Kozobolis, Vassilios


    To develop an algorithm for the Fourier analysis of posterior corneal videokeratographic data and to evaluate the derived parameters in the diagnosis of Subclinical Keratoconus (SKC) and Keratoconus (KC). This was a cross-sectional, observational study that took place in the Eye Institute of Thrace, Democritus University, Greece. Eighty eyes formed the KC group, 55 eyes formed the SKC group while 50 normal eyes populated the control group. A self-developed algorithm in visual basic for Microsoft Excel performed a Fourier series harmonic analysis for the posterior corneal sagittal curvature data. The algorithm decomposed the obtained curvatures into a spherical component, regular astigmatism, asymmetry and higher order irregularities for averaged central 4 mm and for each individual ring separately (1, 2, 3 and 4 mm). The obtained values were evaluated for their diagnostic capacity using receiver operating curves (ROC). Logistic regression was attempted for the identification of a combined diagnostic model. Significant differences were detected in regular astigmatism, asymmetry and higher order irregularities among groups. For the SKC group, the parameters with high diagnostic ability (AUC > 90%) were the higher order irregularities, the asymmetry and the regular astigmatism, mainly in the corneal periphery. Higher predictive accuracy was identified using diagnostic models that combined the asymmetry, regular astigmatism and higher order irregularities in averaged 3and 4 mm area (AUC: 98.4%, Sensitivity: 91.7% and Specificity:100%). Fourier decomposition of posterior Keratometric data provides parameters with high accuracy in differentiating SKC from normal corneas and should be included in the prompt diagnosis of KC. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

  6. The g-2 ring

    CERN Multimedia


    The precise measurement of "g-2", the anomalous magnetic moment of the muon, required a special muon storage ring with electrostatic focussing and very accurate knowledge of the magnetic bending field. For more details see under photo 7405430.

  7. Saturn's dynamic D ring (United States)

    Hedman, M.M.; Burns, J.A.; Showalter, M.R.; Porco, C.C.; Nicholson, P.D.; Bosh, A.S.; Tiscareno, M.S.; Brown, R.H.; Buratti, B.J.; Baines, K.H.; Clark, R.


    The Cassini spacecraft has provided the first clear images of the D ring since the Voyager missions. These observations show that the structure of the D ring has undergone significant changes over the last 25 years. The brightest of the three ringlets seen in the Voyager images (named D72), has transformed from a narrow, <40-km wide ringlet to a much broader and more diffuse 250-km wide feature. In addition, its center of light has shifted inwards by over 200 km relative to other features in the D ring. Cassini also finds that the locations of other narrow features in the D ring and the structure of the diffuse material in the D ring differ from those measured by Voyager. Furthermore, Cassini has detected additional ringlets and structures in the D ring that were not observed by Voyager. These include a sheet of material just interior to the inner edge of the C ring that is only observable at phase angles below about 60??. New photometric and spectroscopic data from the ISS (Imaging Science Subsystem) and VIMS (Visual and Infrared Mapping Spectrometer) instruments onboard Cassini show the D ring contains a variety of different particle populations with typical particle sizes ranging from 1 to 100 microns. High-resolution images reveal fine-scale structures in the D ring that appear to be variable in time and/or longitude. Particularly interesting is a remarkably regular, periodic structure with a wavelength of ??? 30 ?? km extending between orbital radii of 73,200 and 74,000 km. A similar structure was previously observed in 1995 during the occultation of the star GSC5249-01240, at which time it had a wavelength of ??? 60 ?? km. We interpret this structure as a periodic vertical corrugation in the D ring produced by differential nodal regression of an initially inclined ring. We speculate that this structure may have formed in response to an impact with a comet or meteoroid in early 1984. ?? 2006 Elsevier Inc. All rights reserved.

  8. Applanation optical coherence elastography: noncontact measurement of intraocular pressure, corneal biomechanical properties, and corneal geometry with a single instrument (United States)

    Singh, Manmohan; Han, Zhaolong; Nair, Achuth; Schill, Alexander; Twa, Michael D.; Larin, Kirill V.


    Current clinical tools provide critical information about ocular health such as intraocular pressure (IOP). However, they lack the ability to quantify tissue material properties, which are potent markers for ocular tissue health and integrity. We describe a single instrument to measure the eye-globe IOP, quantify corneal biomechanical properties, and measure corneal geometry with a technique termed applanation optical coherence elastography (Appl-OCE). An ultrafast OCT system enabled visualization of corneal dynamics during noncontact applanation tonometry and direct measurement of micro air-pulse induced elastic wave propagation. Our preliminary results show that the proposed Appl-OCE system can be used to quantify IOP, corneal biomechanical properties, and corneal geometry, which builds a solid foundation for a unique device that can provide a more complete picture of ocular health.

  9. Child sex rings.


    Wild, N J; Wynne, J M


    Details of 11 child sex rings identified in one working class community were obtained by interviewing investigating police officers and examining health and social services records. The rings contained 14 adult male perpetrators and 175 children aged 6-15 years. Most perpetrators used child ringleaders to recruit victims; others became a "family friend" or obtained a position of authority over children. Secrecy was encouraged and bribery, threats, and peer pressure used to induce participatio...

  10. Storage ring group summary

    International Nuclear Information System (INIS)

    King, N.M.


    The Storage Ring Group set out to identify and pursue salient problems in accelerator physics for heavy ion fusion, divorced from any particular reference design concept. However, it became apparent that some basic parameter framework was required to correlate the different study topics. As the Workshop progressed, ring parameters were modified and updated. Consequently, the accompanying papers on individual topics will be found to refer to slightly varied parameters, according to the stage at which the different problems were tackled

  11. Matrimonial ring structures


    Hamberger, Klaus; Houseman, Michael; Daillant, Isabelle; White, Douglas R.; Barry, Laurent


    The paper deals with matrimonial rings, a particular kind of cycles in kinship networks which result when spouses are linked to each other by ties of consanguinity or affinity. By taking a network-analytic perspective, the paper endeavours to put this classical issue of structural kinship theory on a general basis, such as to allow conclusions which go beyond isolated discussions of particular ring types (like "cross-cousin marriage", "sister exchange", and so forth). The paper provides a def...

  12. Corneal collagen denaturation in laser thermokeratoplasty (United States)

    Brinkmann, Ralf; Kampmeier, Juergen; Grotehusmann, Ulf; Vogel, Alfred; Koop, Norbert; Asiyo-Vogel, Mary; Birngruber, Reginald


    In laserthermokeratoplasty (LTK) thermal denaturation and shrinkage of corneal collagen is used to correct hyperopia and astigmatism. In order to optimize dosimetry, the temperature at which maximal shrinkage of collagen fibrils occurs is of major interest. Since the exposure time in clinical LTK-treatment is limited to a few seconds, the kinetics of collagen denaturation as a rate process has to be considered, thus the time of exposure is of critical importance for threshold and shrinkage temperatures. We investigated the time-temperature correlation for corneal collagen denaturation within different time domains by turbidimetry of scattered HeNe laser probe light using a temperature controlled water bath and pulsed IR laser irradiation. In the temperature range of 60 degree(s)C to 95 degree(s)C we found an exponential relation between the denaturation time and temperature. For the typical LTK-treatment time of 2 s, a temperature of 95 degree(s)C is needed to induce thermal damage. Use of pulsed Holmium laser radiation gave significant scattering of HeNe laser probe light at calculated temperatures of around 100 degree(s)DC. Rate parameters according to the formalism of Arrhenius were fitted to these results. Force measurements showed the simultaneous onset of light scattering and collagen shrinkage.

  13. Coefficient of Friction of Human Corneal Tissue. (United States)

    Wilson, Tawnya; Aeschlimann, Rudolf; Tosatti, Samuele; Toubouti, Youssef; Kakkassery, Joseph; Osborn Lorenz, Katherine


    A novel property evaluation methodology was used to determine the elusive value for the human corneal coefficient of friction (CoF). Using a microtribometer on 28 fresh human donor corneas with intact epithelia, the CoF was determined in 4 test solutions (≥5 corneas/solution): tear-mimicking solution (TMS) in borate-buffered saline (TMS-PS), TMS in phosphate-buffered saline (TMS-PBS), TMS with HEPES-buffered saline (TMS-HEPES), and tear-like fluid in PBS (TLF-PBS). Mean (SD) CoF values ranged from 0.006 to 0.015 and were 0.013 (0.010) in TMS-PS, 0.006 (0.003) in TMS-PBS, 0.014 (0.005) in TMS-HEPES, and 0.015 (0.009) in TLF-PBS. Statistically significant differences were shown for TMS-PBS versus TLF (P = 0.0424) and TMS-PBS versus TMS-HEPES (P = 0.0179), but not for TMS-PBS versus TMS-PS (P = 0.2389). Successful measurement of the fresh human corneal tissue CoF was demonstrated, with values differing in the evaluated buffer solutions, within this limited sample size.

  14. Clinical utility of the KAMRA corneal inlay (United States)

    Naroo, Shehzad Anjam; Bilkhu, Paramdeep Singh


    The treatment of presbyopia has been the focus of much scientific and clinical research over recent years, not least due to an increasingly aging population but also the desire for spectacle independence. Many lens and nonlens-based approaches have been investigated, and with advances in biomaterials and improved surgical methods, removable corneal inlays have been developed. One such development is the KAMRA™ inlay where a small entrance pupil is exploited to create a pinhole-type effect that increases the depth of focus and enables improvement in near visual acuity. Short- and long-term clinical studies have all reported significant improvement in near and intermediate vision compared to preoperative measures following monocular implantation (nondominant eye), with a large proportion of patients achieving Jaeger (J) 2 to J1 (~0.00 logMAR to ~0.10 logMAR) at the final follow-up. Although distance acuity is reduced slightly in the treated eye, binocular visual acuity and function remain very good (mean 0.10 logMAR or better). The safety of the inlay is well established and easily removable, and although some patients have developed corneal changes, these are clinically insignificant and the incidence appears to reduce markedly with advancements in KAMRA design, implantation technique, and femtosecond laser technology. This review aims to summarize the currently published peer-reviewed studies on the safety and efficacy of the KAMRA inlay and discusses the surgical and clinical outcomes with respect to the patient’s visual function. PMID:27274194

  15. Percent tissue altered and corneal ectasia. (United States)

    Santhiago, Marcony R


    This article reviews the association of a novel metric, percentage tissue altered (PTA), with the occurrence of ectasia after laser in-situ keratomileusis in eyes with normal corneal topography, and analyses the influence of the variables that comprise it, and its role on eyes with suspicious topography. PTA is derived from [PTA = (FT + AD)/CCT] where FT = flap thickness, AD = ablation depth, and CCT = preoperative central corneal thickness. Our studies revealed that there is a robust relationship between high PTA and ectasia risk in eyes with normal preoperative topography. PTA higher or equal to 40% presented the highest odds ratio and highest predictive capabilities for ectasia risk than each of the variables that comprise it, residual stromal bed or age. Average thicker flaps alone were insufficient to create ectasia unless coupled with greater ablation depths, meaning a high PTA. In eyes with suspicious topography, even low PTA value is sufficient to induce ectasia. This new metric, PTA, should be taken into account when screening patients for refractive surgery. Patients with normal topography or tomography, presenting a PTA higher or equal to 40% should be considered at higher risk for post laser in-situ keratomileusis ectasia.

  16. Bilateral Keratectasia 34 Years after Corneal Transplant

    Directory of Open Access Journals (Sweden)

    Xavier Valldeperas


    Full Text Available We report the clinical findings of a patient with severe bilateral keratectasia 34 years after a penetrating keratoplasty (PK in both eyes. An otherwise healthy 67-year-old man complained of deterioration of the eyesight in both eyes over the last 6 months. The patient was diagnosed with bilateral keratoconus at the age of 32 years, and he underwent a bilateral PK. At presentation, visual acuity was 20/200 in the right eye and light perception in the left eye. A Pentacam pachymetric map revealed a central pachymetry of 720 µm in the right eye and of 710 µm in the left eye, as well as an average paracentral pachymetry of 436 and 270 µm in the 9-mm zone in the right and the left eye, respectively. Corneal topography revealed bilateral irregular and asymmetric bowing with generalized steepening and high corneal power. We describe a case of bilateral keratectasia 34 years after PK in a patient who was originally diagnosed with bilateral keratoconus.

  17. [New stimulants of corneal reparative regeneration]. (United States)

    Egorov, E A; Kalinin, N I; Kiiasov, A P


    The efficacy of corneregel, a drug containing pantothenic acid, a component of coenzyme A, in healing of corneal wounds has been evaluated. The study was carried out on 19 rabbits (38 eyes) with standard corneal defect made with a 5-mm trephine for lamellar transplantation of the cornea, divided into 2 groups: 1) instillations of corneregel (10 eyes) and 0.25% levomycetin solution (10 eyes) and 2) 20% solcoseryl gel (9 eyes) and 0.25% levomycetin (9 eyes). Time course of changes were evaluated by biomicroscopy (fluorescent test), histologically (hematoxylin-eosin staining), and immunohistochemically after 1, 2, 4, 7, 30, and 90 days. Proliferative activity was studied by expression of the proliferating cell nuclear antigen and the migration capacity of cells by expression of alpha-smooth muscle actin. The terms of epithelialization were as follows: corneregel 10 +/- 7 h, 20% solcoseryl gel 108 +/- 10 h, levomycetin 124 +/- 6.93 h. Earlier epithelialization in the corneregel group was apparently due to increased expression of alpha-smooth muscle actin and increase in the cell migration capacity. Hence, corneregel is recommended for practical use as a stimulant of reparative regeneration of the cornea.

  18. Corneal endothelial glutathione after photodynamic change

    International Nuclear Information System (INIS)

    Hull, D.S.; Riley, M.V.; Csukas, S.; Green, K.


    Rabbit corneal endothelial cells perfused with 5 X 10(-6)M rose bengal and exposed to incandescent light demonstrated no alteration of either total of or percent oxidized glutathione after 1 hr. Addition of 5400 U/ml catalase to the perfusing solution had no effect on total glutathione levels but caused a marked reduction in percent oxidized glutathione in corneas exposed to light as well as in those not exposed to light. Substitution of sucrose for glucose in the perfusing solution had no effect on total or percent oxidized glutathione. Perfusion of rabbit corneal endothelium with 0.5 mM chlorpromazine and exposure to ultraviolet (UV) light resulted in no change in total glutathione content. A marked reduction in percent oxidized glutathione occurred, however, in corneas perfused with 0.5 mM chlorpromazine both in the presence and absence of UV light. It is concluded that photodynamically induced swelling of corneas is not the result of a failure of the glutathione redox system

  19. Topographic corneal changes after collagen cross-linking in patients with corneal keratoconus

    Directory of Open Access Journals (Sweden)

    Hasan Razmjoo


    Full Text Available Background: Corneal collagen cross-linking with riboflavin, also known as collagen cross-linking (CXL, involves the application of riboflavin solution to the eye that is activated by illumination with ultraviolet A (UVA light. We survey here the topographic corneal changes one year after CXL in patients with corneal keratoconus. Materials and Methods: This prospective randomized clinical trial study comprised 66 patients with progression of keratoconus during one year who were enrolled at Feiz University Referral Eye Center in Isfahan. Before and after the operation, patients were examined with slit lamp and funduscopic examinations and measurement of uncorrected visual acuity (UCVA, and best spectacle-corrected visual acuity (BSCVA was done with a logarithm of minimal angle of resolution (logMAR scale. Corneal topographic and pachymetry values were derived from Orbscan II. The paired t-test test was used for statistical analyses with SPSS software version 20 (SPSS Inc., Chicago, IL, USA. Results: All 66 patients completed postoperative follow-up at 12 months. The mean age of the patients was 22.4 ± 5.4 years (range: 18-29 years. Thirty-six (54.55% subjects were men and 30 (45.45% were women. The mean preoperative sphere was −2.66 ± 2.14 diopter (D, the mean cylinder was −3.97 ± 2.29, and the mean spherical equivalent (SE was −4.64 ± 2.56. Postoperatively, the mean sphere was −2.22 ± 2.57 D, the mean cylinder was −3.60 ± 2.40 D, and SE was −4.02 ± 2.93 D (P = 0.037. SE also demonstrated a mean difference of 0.62 ± 0.37 D significantly (P = 0.006.The mean diameter of preoperative posterior best-fit sphere (BFS was 6.33 ± 0.35mm (range: 5.51-7.73 mm before operation, and it improved to 6.28 ± 0.34mm (range: 4.36-6.13 mm after operation; the difference was significant (P = 0.039. Conclusion: Our study showed a significant improvement in topographic corneal changes and refractive results in patients with corneal ectasia after

  20. Corneal power evaluation after myopic corneal refractive surgery using artificial neural networks. (United States)

    Koprowski, Robert; Lanza, Michele; Irregolare, Carlo


    Efficacy and high availability of surgery techniques for refractive defect correction increase the number of patients who undergo to this type of surgery. Regardless of that, with increasing age, more and more patients must undergo cataract surgery. Accurate evaluation of corneal power is an extremely important element affecting the precision of intraocular lens (IOL) power calculation and errors in this procedure could affect quality of life of patients and satisfaction with the service provided. The available device able to measure corneal power have been tested to be not reliable after myopic refractive surgery. Artificial neural networks with error backpropagation and one hidden layer were proposed for corneal power prediction. The article analysed the features acquired from the Pentacam HR tomograph, which was necessary to measure the corneal power. Additionally, several billion iterations of artificial neural networks were conducted for several hundred simulations of different network configurations and different features derived from the Pentacam HR. The analysis was performed on a PC with Intel ® Xeon ® X5680 3.33 GHz CPU in Matlab ® Version (R2010b) with Signal Processing Toolbox Version 7.1 (R2010b), Neural Network Toolbox 7.0 (R2010b) and Statistics Toolbox (R2010b). A total corneal power prediction error was obtained for 172 patients (113 patients forming the training set and 59 patients in the test set) with an average age of 32 ± 9.4 years, including 67% of men. The error was at an average level of 0.16 ± 0.14 diopters and its maximum value did not exceed 0.75 dioptres. The Pentacam parameters (measurement results) providing the above result are tangential anterial/posterior. The corneal net power and equivalent k-reading power. The analysis time for a single patient (a single eye) did not exceed 0.1 s, whereas the time of network training was about 3 s for 1000 iterations (the number of neurons in the hidden layer was 400).

  1. Advances in femtosecond laser technology

    Directory of Open Access Journals (Sweden)

    Callou TP


    Full Text Available Thais Pinheiro Callou, Renato Garcia, Adriana Mukai, Natalia T Giacomin, Rodrigo Guimarães de Souza, Samir J Bechara Department of Ophthalmology, University of Sao Paulo, Sao Paulo, Brazil Abstract: Femtosecond laser technology has become widely adopted by ophthalmic surgeons. The purpose of this study is to discuss applications and advantages of femtosecond lasers over traditional manual techniques, and related unique complications in cataract surgery and corneal refractive surgical procedures, including: LASIK flap creation, intracorneal ring segment implantation, presbyopic treatments, keratoplasty, astigmatic keratotomy, and intrastromal lenticule procedures. Keywords: laser therapy, refractive surgical procedures, intracorneal ring, laser in situ keratomileusis, keratoplasty, presbyopia, cataract extraction, astigmatism surgery

  2. Punctiform and Polychromatophilic Dominant Pre-Descemet Corneal Dystrophy. (United States)

    Lagrou, Lisa; Midgley, Julian; Romanchuk, Kenneth Gerald


    To describe the slit-lamp appearance and corneal confocal microscopy of autosomal dominant punctiform and polychromatophilic pre-Descemet corneal dystrophy in 3 members of the same family. Slit-lamp examination of a 9-year-old boy showed bilateral polychromatophilic corneal opacities in a pre-Descemet membrane location evenly deposited limbus to limbus, both horizontally and vertically, with an intervening clear cornea. The corneal endothelium was normal on corneal confocal microscopy, with hyperreflective opacities of various sizes located pre-Descemet membrane. Slit-lamp examination of the patient's father and brother revealed identical crystalline deposition in the pre-Descemet corneal stroma. The remainders of the eye examinations were otherwise normal in all 3 individuals, and all were asymptomatic. The general physical examination and laboratory investigations of the patient were all normal, as were the laboratory investigations of the other 2 family members. There was no progression in the corneal findings over 6 months of follow-up. These patients likely illustrate a rare autosomal dominant pre-Descemet crystalline keratopathy that has been reported only once previously.

  3. Corneal Higher-Order Aberrations in Infectious Keratitis. (United States)

    Shimizu, Eisuke; Yamaguchi, Takefumi; Yagi-Yaguchi, Yukari; Dogru, Murat; Satake, Yoshiyuki; Tsubota, Kazuo; Shimazaki, Jun


    To characterize the corneal higher-order aberrations (HOAs) in eyes with Acanthamoeba keratitis (AK), bacterial keratitis (BK), and fungal keratitis (FK). Retrospective consecutive case series. This retrospective study includes 18 normal subjects and 63 eyes of 62 consecutive patients with corneal scarring due to AK (20 eyes), BK (35 eyes), and FK (8 eyes) from 2010 to 2016. HOAs of the anterior and posterior surfaces and the total cornea were analyzed by anterior segment optical coherence tomography. Corneal HOA patterns were assigned on the basis of corneal topography maps. Corneal opacity grading was assigned on the basis of slit-lamp examinations. We evaluated corneal HOAs, corneal opacity grading, and their correlation with visual acuity. HOAs of the total cornea within a 4-mm diameter were significantly larger in eyes with infectious keratitis (AK, 1.15 ± 2.06 μm; BK, 0.91 ± 0.88 μm; FK, 1.39 ± 1.46 μm) compared with normal controls (0.09 ± 0.01 μm, all, P keratitis were associated with poorer visual acuity values. Asymmetric pattern was the most common topographic pattern in infectious keratitis. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications (United States)

    Ambrósio, Jr, Renato; Correia, Fernando Faria; Lopes, Bernardo; Salomão, Marcella Q.; Luz, Allan; Dawson, Daniel G.; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Roberts, Cynthia J.


    Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. Method: The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea. Conclusions: The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy. PMID:28932334

  5. Topical ranibizumab as a treatment of corneal neovascularization. (United States)

    Ferrari, Giulio; Dastjerdi, Mohammad H; Okanobo, Andre; Cheng, Sheng-Fu; Amparo, Francisco; Nallasamy, Nambi; Dana, Reza


    To examine the effect of topical ranibizumab on clinically stable corneal neovascularization (NV). This was a prospective, open-label, monocentric, uncontrolled noncomparative study. Ten eyes of 9 patients with corneal NV received topical ranibizumab (1%) 4 times a day for 3 weeks with a follow-up period of 16 weeks. The main corneal NV outcome measures were: neovascular area, the area occupied by the corneal neovessels; vessel caliber (VC), the mean diameter of the corneal neovessels; and invasion area (IA), the fraction of the total cornea area covered by the vessels. This study was conducted at the Massachusetts Eye and Ear Infirmary, Boston, MA. Statistically significant decreases in neovascular area (55.3%, P < 0.001), which lasted through 16 weeks, and VC (59%, P < 0.001), which continued to improve up to week 16, were observed after treatment. No significant decrease was observed in IA (12.3%, P = 0.49). There was no statistically significant change in visual acuity or intraocular pressure. No adverse events ascribed to the treatment were noted. Topical application of ranibizumab is effective in reducing the severity of corneal NV in the context of established corneal NV, mostly through decrease in VC rather than IA.

  6. Modeling Corneal Oxygen with Scleral Gas Permeable Lens Wear. (United States)

    Compañ, Vicente; Aguilella-Arzo, Marcel; Edrington, Timothy B; Weissman, Barry A


    The main goal of this current work is to use an updated calculation paradigm, and updated boundary conditions, to provide theoretical guidelines to assist the clinician whose goal is to improve his or her scleral gas permeable (GP) contact lens wearing patients' anterior corneal oxygen supply. Our model uses a variable value of corneal oxygen consumption developed through Monod equations that disallows negative oxygen tensions within the stroma to predict oxygen tension at the anterior corneal surface of scleral GP contact lens wearing eyes, and to describe oxygen tension and flux profiles, for various boundary conditions, through the lens, tears, and cornea. We use several updated tissue and boundary parameters in our model. Tear exchange with GP scleral lenses is considered nonexistent in this model. The majority of current scleral GP contact lenses should produce some levels of corneal hypoxia under open eye conditions. Only lenses producing the thinnest of tear vaults should result in anterior corneal surface oxygen tensions greater than a presumed critical oxygen tension of 100 mmHg. We also find that corneal oxygen tension and flux are each more sensitive to modification in tear vault than to changes in lens oxygen permeability, within the ranges of current clinical manipulation. Our study suggests that clinicians would be prudent to prescribe scleral GP lenses manufactured from higher oxygen permeability materials and especially to fit without excessive corneal clearance.

  7. Impact of Hydration Media on Ex Vivo Corneal Elasticity Measurements. (United States)

    Dias, Janice; Ziebarth, Noël M


    To determine the effect of hydration media on ex vivo corneal elasticity. Experiments were conducted on 40 porcine eyes retrieved from an abattoir (10 eyes each for phosphate-buffered saline (PBS), balanced salt solution, Optisol, 15% dextran). The epithelium was removed, and the cornea was excised with an intact scleral rim and placed in 20% dextran overnight to restore its physiological thickness. For each hydration media, corneas were evenly divided into two groups: one with an intact scleral rim and the other without. Corneas were mounted onto a custom chamber and immersed in a hydration medium for elasticity testing. Although in each medium, corneal elasticity measurements were performed for 2 hr: at 5-min intervals for the first 30 min and then 15-min intervals for the remaining 90 min. Elasticity testing was performed using nanoindentation with spherical indenters, and Young modulus was calculated using the Hertz model. Thickness measurements were taken before and after elasticity testing. The percentage change in corneal thickness and elasticity was calculated for each hydration media group. Balanced salt solution, PBS, and Optisol showed an increase in thickness and Young moduli for corneas with and without an intact scleral rim. Fifteen percent dextran exhibited a dehydrating effect on corneal thickness and provided stable maintenance of corneal elasticity for both groups. Hydration media affects the stability of corneal thickness and elasticity measurements over time. Fifteen percent dextran was most effective in maintaining corneal hydration and elasticity, followed by Optisol.

  8. Topical Ranibizumab as a Treatment of Corneal Neovascularization (United States)

    Ferrari, Giulio; Dastjerdi, Mohammad H.; Okanobo, Andre; Cheng, Sheng-Fu; Amparo, Francisco; Nallasamy, Nambi; Dana, Reza


    Purpose To examine the effect of topical ranibizumab on clinically stable corneal neovascularization (NV). Methods This was a prospective, open-label, monocentric, uncontrolled, non-comparative study. Ten eyes of 9 patients with corneal NV received topical ranibizumab (1%) 4 times a day for 3 weeks with a follow-up of 16 weeks. The main corneal neovascularization outcome measures were: neovascular area (NA), the area occupied by the corneal neovessels; vessel caliber (VC), the mean diameter of the corneal neovessels; and invasion area (IA), the fraction of the total cornea area covered by the vessels. This study was conducted at the Massachusetts Eye and Ear Infirmary, Boston, MA, USA. Results Statistically significant decreases in NA (55.3%, P<0.001), which lasted through 16 weeks, and VC (59%, P<0.001), which continued to improve up to week 16, were observed after treatment. No significant decrease was observed in IA (12.3%, P=0.49). There was no statistically significant change in visual acuity or intraocular pressure. No adverse events ascribed to the treatment were noted. Conclusions Topical application of ranibizumab is effective in reducing the severity of corneal NV in the context of established corneal NV, mostly through decrease in VC rather than IA. PMID:23407316

  9. Corneal ectasia secondary to peripheral endotheliopathy in a patient with classic pars planitis


    Arellanes-Garcia, Lourdes; Preciado-Delgadillo, Maricarmen; Hernandez-Quintela, Everardo; Garza-Leon, Manuel


    Purpose To report a case of corneal ectasia secondary to pars planitis corneal endotheliopathy Methods Clinical case description and proposed hypothesis regarding development of corneal ectasia Results Eight-year-old male presented with 360° peripheral corneal endotheliopathy and edema, granulomatous keratic precipitates, and mild iritis OD. A progressive corneal ectasia then developed. Twenty months later, OS presented similarly and anterior chamber inflammatory cells, vitreous snowballs, an...

  10. Blepharokeratoconjunctivitis in childhood: corneal involvement and visual outcome. (United States)

    Rodríguez-García, A; González-Godínez, S; López-Rubio, S


    The main objective of this study is to describe the prevalence, degree and risk of corneal involvement, and visual impact in a pediatric population with blepharokeratoconjunctivitis (BKC). Retrospective, observational, case-control study. Clinical records of patients ≤16 years old with BKC seen between 2006 and 2012 were reviewed. The prevalence and relative risk of corneal involvement was evaluated between patients with and without corneal affection through a univariate and multivariate analysis with logistic regression. Visual acuity at presentation and at last follow-up visit was also analyzed. One hundred and fourteen children with BKC, with a male-to-female ratio of 1 : 1 and a mean age at diagnosis of 9.13 years. The mean follow-up time was 26.4 (±25) months. Corneal involvement was present in 39.5% of patients, varying from superficial punctate keratitis to perforation. Corneal changes were not seen in children under 4 years old. The risk of corneal affection was greater in patients with photophobia, hordeolum, female gender and asymmetric disease (OR of 2.69, 11.6, 2.35 and 2.77, respectively). The mean best-corrected visual acuity at presentation was 0.20 (corneal affected group), compared to 0.11 (unaffected group; P=0.02). Our study showed an older age at time of diagnosis and a worse visual outcome in patients with BKC and corneal disease compared with previous reports. Early diagnosis and detection of risk factors for corneal involvement, as well as adequate treatment, is mandatory to prevent serious long-term visual repercussions in children with BKC.

  11. Using corneal topography design personalized cataract surgery programs

    Directory of Open Access Journals (Sweden)

    Jin-Ou Huang


    Full Text Available AIM:To investigate how to design personalized cataract surgery programs to achieve surgical correction of preoperative corneal astigmatism with surgical astigmatism under the guidance of corneal topography, improve postoperative visual quality and reduce the cost of treatment. METHODS: Totally 202 cases(226 eyescataract patients were divided into randomized treatment group and individualized treatment group. According to the method and location of the incision, randomized treatment group were divided into 8 groups. Surgical astigmatism after different incision were calculated with the use of preoperative and postoperative corneal astigmatism through vector analysis method. Individualized treatment groups were designed personably for surgical method with reference of every surgically induced astigmatism, the surgical method chooses the type of surgical incision based on close link between preoperative corneal astigmatism and surgically induced astigmatism, and the incision was located in the steep meridian. The postoperative corneal astigmatism of individualized treatment group was observed. RESULTS: Postoperative corneal astigmatism of individualized treatment group were lower than that of 3.0mm clear corneal tunnel incision in the randomized treatment group, there were statistically significance difference, while with 3.0mm sclera tunnel incision group there were no statistically significance difference. After 55.8% of patients with the use of individualized surgical plan could undergo the operation of extracapsular cataract extraction with relatively low cost and rigid intraocular lens implantation, the per capita cost of treatment could be reduced. CONCLUSION: Personalized cataract surgery programs are designed to achieve surgical correction of preoperative corneal astigmatism under the use of corneal topography, improve postoperative visual quality and reduce the cost of treatment.

  12. Impact of facial conformation on canine health: corneal ulceration. (United States)

    Packer, Rowena M A; Hendricks, Anke; Burn, Charlotte C


    Concern has arisen in recent years that selection for extreme facial morphology in the domestic dog may be leading to an increased frequency of eye disorders. Corneal ulcers are a common and painful eye problem in domestic dogs that can lead to scarring and/or perforation of the cornea, potentially causing blindness. Exaggerated juvenile-like craniofacial conformations and wide eyes have been suspected as risk factors for corneal ulceration. This study aimed to quantify the relationship between corneal ulceration risk and conformational factors including relative eyelid aperture width, brachycephalic (short-muzzled) skull shape, the presence of a nasal fold (wrinkle), and exposed eye-white. A 14 month cross-sectional study of dogs entering a large UK based small animal referral hospital for both corneal ulcers and unrelated disorders was carried out. Dogs were classed as affected if they were diagnosed with a corneal ulcer using fluorescein dye while at the hospital (whether referred for this disorder or not), or if a previous diagnosis of corneal ulcer(s) was documented in the dogs' histories. Of 700 dogs recruited, measured and clinically examined, 31 were affected by corneal ulcers. Most cases were male (71%), small breed dogs (mean± SE weight: 11.4±1.1 kg), with the most commonly diagnosed breed being the Pug. Dogs with nasal folds were nearly five times more likely to be affected by corneal ulcers than those without, and brachycephalic dogs (craniofacial ratio ulcer risk. Exposed eye-white was associated with a nearly three times increased risk. The results demonstrate that artificially selecting for these facial characteristics greatly heightens the risk of corneal ulcers, and such selection should thus be discouraged to improve canine welfare.

  13. Pharmacologic strategies in the prevention and treatment of corneal transplant rejection. (United States)

    Tabbara, Khalid F


    Corneal transplantation remains one of the most successful organ transplantation procedures in humans. The unique structure of the cornea, with its absence of blood vessels and corneal lymphatic, allows the survival of corneal allograft. Recent advances in sutures, storage media, microsurgical instrumentation, and new pharmacological strategies have greatly improved the success of corneal transplantation and the prevention of corneal allograft rejection. Our strategies in the management and prevention of corneal graft rejection can modify and improve the survival of corneal allografts. Preoperative evaluation, understanding the risk factors, and management of ocular surface disorders may greatly improve the survival of the corneal transplant. Early recognition of corneal allograft rejection and aggressive treatment may improve the survival of the corneal graft. Furthermore, patients who undergo corneal transplantation should be maintained under close ophthalmic surveillance and patients should be informed to report immediately whenever symptoms of corneal graft rejection occur. The mainstay of therapy is topical corticosteroids. In severe cases, periocular, intravenous, and oral corticosteroids therapy can be rendered. New therapeutic modalities such as cyclosporine, tacrolimus, daclizumab, mycophenolate mofetil, leflunomide, rapamycin, and others may prove to be of help in the prevention and treatment of corneal graft rejection. Early recognition of corneal graft rejection and prompt treatment are mandatory for the successful survival of the corneal allograft.

  14. Methylene blue-related corneal edema and iris discoloration. (United States)

    Timucin, Ozgur Bulent; Karadag, Mehmet Fatih; Aslanci, Mehmet Emin; Baykara, Mehmet


    We report the case of a 70-year-old female patient who developed corneal edema and iris discoloration following the inadvertent use of 1% methylene blue instead of 0.025% trypan blue to stain the anterior capsule during cataract phacoemulsification surgery. Copious irrigation was performed upon realization of incorrect dye use. Corneal edema and iris discoloration developed during the early postoperative period and persisted at 24-months follow-up. However, keratoplasty was not required. The intracameral use of 1% methylene blue has a cytotoxic effect on the corneal endothelium and iris epithelium. Copious irrigation for at least 30 min using an anterior chamber maintainer may improve outcomes.

  15. Pseudomonas-induced corneal ulcers associated with contaminated eye mascaras. (United States)

    Wilson, L A; Ahearn, D G


    Seven Pseudomonas-induced corneal ulcers were associated with the use of four brands of mascara contaminated with P. aeruginosa. In laboratory studies, preservative systems of three of the four brands were inadequate in comparison with a control mascara of known antimicrobial activity. If the corneal epithelium is scratched during the application of mascara, particularly if the applicator is old, the cornea should be treated immediately and the mascara cultured to detect Pseudomonas. The high incidence of recurrent corneal ulceration in cases of Pseudomonas-induced keratitis indicates that initial chemotherapy should be intensive and maintained until the lesion stabilizes.

  16. Corneal perforation secondary to UV radiation from a tanning lamp. (United States)

    Funnell, Charlotte; Watson, Keith; Stewart, Owen; Dua, Gurcharan


    To report the case of a patient with keratoconus who developed a corneal perforation secondary to UV radiation from a tanning lamp. We believe this to be the first case of a corneal perforation secondary to UV radiation. The presentation and management of the patient and the pathophysiology of UV keratitis are discussed. Our patient developed a full-thickness corneal perforation after 30 minutes of tanning lamp exposure without eye protection. The cornea was temporized with cyanoacrylate tissue adhesive until penetrating keratoplasty could be performed. With an increased understanding of the pathophysiology of UV damage, treatment should be aimed at modulating the disease to reduce the likelihood of a poor outcome.

  17. Corneal endothelial cell density and morphology in healthy Turkish eyes. (United States)

    Arıcı, Ceyhun; Arslan, Osman Sevki; Dikkaya, Funda


    Purpose. To describe the normative values of corneal endothelial cell density, morphology, and central corneal thickness in healthy Turkish eyes. Methods. Specular microscopy was performed in 252 eyes of 126 healthy volunteers (M : F, 42 : 84). Parameters studied included mean endothelial cell density (MCD), mean cell area (MCA), coefficient of variation (CV) in cell size, percentage of hexagonal cells, and central corneal thickness (CCT). Results. The mean age of volunteers was 44.3 ± 13.5 (range, 20 to 70) years. There was a statistically significant decrease in MCD (P Filipino eyes and higher than that described in Indian, Thai, and Iranian eyes.

  18. Repositioning of pedicle conjunctival flap performed for refractory corneal ulcer. (United States)

    Sharma, Ashok; Mohan, Kanwar; Sharma, Rajan; Nirankari, Verinder S


    A 50-year-old male was referred with a previous history of conjunctival flap (CF) for a nonhealing fungal corneal ulcer with extreme corneal thinning in the right eye. The peritomy for the CF extended from 6:30 to 9:30 clock h on the cornea. The CF was disengaged, peritomy area deepithelialized, and CF was repositioned. He later underwent penetrating keratoplasty and achieved 20/40 best corrected visual acuity. The authors present a new concept for surgically repositioning CF s to the original site immediately after healing of the corneal ulcer.

  19. Infiltrados corneales asociados al uso de lentes de contacto Corneal infiltrates associated with contact lens wear

    Directory of Open Access Journals (Sweden)

    Vivian Padrón Álvarez


    Full Text Available Se estudiaron 15 pacientes que usan lentes de contacto rígidas, permeables al gas (LCRPG y lentes de contacto blandas (LCB que presentaron infiltrados corneales. Se realizó estudio microbiológico de las lesiones y seguimiento clínico de estos casos. En 3 de los casos estudiados el cultivo fue positivo a estafilococo aureus, el resto de los estudios microbiológicos fueron negativos. Todos los pacientes respondieron rápidamente al retirar la lente de contacto y al tratamiento con antibióticos tópicos y ninguno tuvo afectación permanente de la agudeza visual. El diagnóstico exacto y el manejo apropiado de los infiltrados corneales en pacientes que usan lentes de contacto es de gran importancia por la posibilidad de infección o de secuela visual permanente.15 patients wearing gas permeable rigid contact lenses (GPRCL and soft contanct lenses (SCL that presented corneal infiltrates were studied. A microbiological study of the injuries and a clinical follow-up of these cases were conducted. In 3 of the studied cases the culture was positive to Staphyloccocus aureus. The rest of the mircobiological studies were negative. All the patients responded rapidly to the contact lens removal and to the treatment with topical antibiotics. None of them had permanent affection of visual acuity. The accurate diagnosis and the appropiate management of the corneal infiltrates in patients wearing contact lenses is very important due to the possibility of infection or of permanent visual sequela.

  20. BERKELEY: ALS ring

    International Nuclear Information System (INIS)



    Everybody at Lawrence Berkeley Laboratory's Center for Beam Physics is pleased with the rapid progress in commissioning LBL's Advanced Light Source (ALS) electron storage ring, the foundation for this third-generation synchrotron radiation facility. Designed for a maximum current of 400 mA, the ALS storage ring reached 407 mA just 24 days after storing the first beam on 16 March. ALS construction as a US Department of Energy (DOE) national user facility to provide high-brightness vacuum ultra-violet and soft x-ray radiation began in October 1987. One technical requirement marking project completion was to accumulate a 50-mA current in the storage ring. The ALS passed this milestone on 24 March, a week ahead of the official deadline. Once injected, the electron beam decays quasi-exponentially primarily because of interactions with residual gas molecules in the storage-ring vacuum chamber. Eventually, when the pressure in the vacuum chamber with beam decreases toward the expected operating level of 1 nano Torr, it will only be necessary to refill the storage ring at intervals of four to eight hours. At present the vacuum is improving rapidly as surfaces are irradiated (scrubbed) by the synchrotron radiation itself. At 100 mA, beam lifetime was about one hour (9 April)

  1. Refractive cylinder outcomes after calculating toric intraocular lens cylinder power using total corneal refractive power

    Directory of Open Access Journals (Sweden)

    Davison JA


    Full Text Available James A Davison,1 Richard Potvin21Wolfe Eye Clinic, Marshalltown, IA, USA; 2Science in Vision, Akron, NY, USAPurpose: To determine whether the total corneal refractive power (TCRP value, which is based on measurement of both anterior and posterior corneal astigmatism, is effective for toric intraocular lens (IOL calculation with AcrySof® Toric IOLsPatients and methods: A consecutive series of cataract surgery cases with AcrySof toric IOL implantation was studied retrospectively. The IOLMaster® was used for calculation of IOL sphere, the Pentacam® TCRP 3.0 mm apex/ring value was used as the keratometry input to the AcrySof Toric IOL Calculator and the VERION™ Digital Marker for surgical orientation. The keratometry readings from the VERION reference unit were recorded but not used in the actual calculation. Vector differences between expected and actual residual refractive cylinder were calculated and compared to simulated vector errors using the collected VERION keratometry data.Results: In total, 83 eyes of 56 patients were analyzed. Residual refractive cylinder was 0.25 D or lower in 58% of eyes and 0.5 D or lower in 80% of eyes. The TCRP-based calculation resulted in a statistically significantly lower vector error (P<0.01 and significantly more eyes with a vector error ≤0.5 D relative to the VERION-based calculation (P=0.02. The TCRP and VERION keratometry readings suggested a different IOL toric power in 53/83 eyes. In these 53 eyes the TCRP vector error was lower in 28 cases, the VERION error was lower in five cases, and the error was equal in 20 cases. When the anterior cornea had with-the-rule astigmatism, the VERION was more likely to suggest a higher toric power and when the anterior cornea had against-the-rule astigmatism, the VERION was less likely to suggest a higher toric power.Conclusion: Using the TCRP keratometry measurement in the AcrySof toric calculator may improve overall postoperative refractive results

  2. Use of the Femtosecond Lasers in Ophthalmology (United States)

    Roszkowska, Anna M.; Urso, Mario; Signorino, Alberto; Aragona, Pasquale


    Femtosecond laser (FSL) is an infrared laser with a wavelength of 1053 nm. FS laser works producing photodisruption or photoionization of the optically transparent tissue such as cornea. Currently FS lasers have a wide range of applications in ophthalmic surgery. They are used above all in corneal surgery in refractive procedures and keratoplasty, and recently in cataract surgery. The use of the FSL in corneal refractive surgery includes LASIK flap creation, astigmatic keratotomy, Femtosecond Lenticule Extraction (FLEx), Small Incision Lenticule Extraction (SMILE) and channels creation for implantation of the intrastromal corneal rings. As to the corneal grafting, the FS lasers are used in laser-assisted anterior and posterior lamellar keratoplasty and customized trephination in the penetrating keratoplasty. FS Laser Assisted Cataract Surgery (FLACS) includes capsulorrhexis and nuclear fragmentation that enhance safety and efficacy of the procedure.

  3. Corneal stromal demarcation line after collagen cross-linking in corneal ectatic diseases: a review of the literature

    Directory of Open Access Journals (Sweden)

    Spadea L


    Full Text Available Leopoldo Spadea, Emanuele Tonti, Enzo Maria Vingolo Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy Abstract: Collagen cross-linking (CXL is a relatively new conservative approach for progressive corneal ectasia, which is able to strengthen corneal tissue reforming new covalent bonds. Subjective and objective results following this method seem to be promising. In recent years, newer CXL protocols have been developed to perform more effective and less invasive procedures. The increasing diffusion of CXL in the corneal ectatic disease has increased the need to have actual indices regarding the efficacy of the treatment. Evaluation of demarcation line (DL, a transition zone between the cross-linked anterior corneal stroma and the untreated posterior corneal stroma, is considered a measurement of the depth of CXL treatment into the stroma. Some evidence in the literature emphasize that DL could be a measure of effectiveness of the CXL. On the contrary, some authors believe that the “the deeper, the better” principle is rather a simplistic approach for interpreting the clinical importance of the corneal stromal DL. Keywords: corneal cross-linking, demarcation line, keratoconus, ultraviolet A

  4. U.S. Multicenter Clinical Trial of Corneal Collagen Crosslinking for Treatment of Corneal Ectasia after Refractive Surgery. (United States)

    Hersh, Peter S; Stulting, R Doyle; Muller, David; Durrie, Daniel S; Rajpal, Rajesh K


    To evaluate the safety and efficacy of corneal collagen crosslinking (CXL) for the treatment of corneal ectasia after laser refractive surgery. Prospective, randomized, multicenter, controlled clinical trial. One hundred seventy-nine subjects with corneal ectasia after previous refractive surgery. The treatment group underwent standard CXL, and the sham control group received riboflavin alone without removal of the epithelium. The primary efficacy criterion was the change over 1 year of topography-derived maximum keratometry (K), comparing treatment with control groups. Secondary outcomes evaluated were corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent, endothelial cell count, and adverse events. In the crosslinking treatment group, the maximum K value decreased by 0.7 diopters (D) from baseline to 1 year, whereas there was continued progression in the control group (1.3 D difference between treatment and control, P Corneal haze was the most frequently reported crosslinking-related adverse finding. Corneal collagen crosslinking was effective in improving the maximum K value, CDVA, and UDVA in eyes with corneal ectasia 1 year after treatment, with an excellent safety profile. CXL is the first approved procedure to diminish progression of this ectatic corneal process. Copyright © 2017 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  5. Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report

    Directory of Open Access Journals (Sweden)

    Mehmet Balcı


    Full Text Available ABSTRACTWe report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

  6. Depósitos corneales de ciprofloxacino Corneal deposits of ciprofloxacin

    Directory of Open Access Journals (Sweden)

    Taimi Cárdenas Díaz


    Full Text Available Las fluoroquinolonas son ampliamente utilizadas para el tratamiento de infecciones oculares bacterianas, ya que tienen actividad tanto para grampositivos, como para gramnegativos. Son fármacos seguros, pero se han descrito depósitos blancos cristalinianos en pacientes con administración frecuente y prolongada;en la mayoría de los casos, ellos resuelven de forma lenta al interrumpir el tratamiento. Si esto no ocurre, los depósitos se deben desbridar. Se ilustran 3 casos operados de catarata que llevaron tratamiento con ciprofloxacino en el posoperatorio, en los cuales se presentaron depósitos corneales y aunque disminuyó la agudeza visual, esta se recuperó después de la queratectomía.Fluoroquinolones are broadly used for the treatment of bacterial ocular infections, since they can act upon both grampositive and gramnegative bacteria. They are safe drugs, but white corneal deposits have been described in patients who frequently take this drug for a long period of time. In most of the cases, the deposits disappear slowly after the treatment is interrupted. If this does not happen, the deposits should be eliminated. Three cases operated on from cataract were presented, who had been taken ciprofloxacin in the postoperative stage and had corneal deposits. Although their visual acuity decreased, it recovered after keratectomy.

  7. Validation of Na,K-ATPase pump function of corneal endothelial cells for corneal regenerative medicine. (United States)

    Hatou, Shin; Higa, Kazunari; Inagaki, Emi; Yoshida, Satoru; Kimura, Erika; Hayashi, Ryuhei; Tsujikawa, Motokazu; Tsubota, Kazuo; Nishida, Kohji; Shimmura, Shigeto


    Tissue-engineering approaches to cultivate corneal endothelial cells (CECs) or induce CECs from stem cells are under investigation for the treatment of endothelial dysfunction. Before clinical application, a validation method to determine the quality of these cells is required. In this study, we quantified the endothelial pump function required for maintaining the corneal thickness using rabbit CECs (RCECs) and a human CEC line (B4G12). The potential difference of RCECs cultured on a permeable polyester membrane (Snapwell), B4G12 cells on Snapwell, or B4G12 cells on a collagen membrane (CM6) was measured by an Ussing chamber system, and the effect of different concentrations of ouabain (Na,K-ATPase specific inhibitor) was obtained. A mathematical equation derived from the concentration curve revealed that 2 mM ouabain decreases pump function of RCECs to 1.0 mV, and 0.6 mM ouabain decreases pump function of B4G12 on CM6 to 1.0 mV. Ouabain injection into the anterior chamber of rabbit eyes at a concentration of pump function >1.0 mV is required to maintain the corneal thickness. These results can be used for standardization of CEC pump function and validation of tissue-engineered CEC sheets for clinical use.

  8. Generation of corneal epithelial cells from induced pluripotent stem cells derived from human dermal fibroblast and corneal limbal epithelium.

    Directory of Open Access Journals (Sweden)

    Ryuhei Hayashi

    Full Text Available Induced pluripotent stem (iPS cells can be established from somatic cells. However, there is currently no established strategy to generate corneal epithelial cells from iPS cells. In this study, we investigated whether corneal epithelial cells could be differentiated from iPS cells. We tested 2 distinct sources: human adult dermal fibroblast (HDF-derived iPS cells (253G1 and human adult corneal limbal epithelial cells (HLEC-derived iPS cells (L1B41. We first established iPS cells from HLEC by introducing the Yamanaka 4 factors. Corneal epithelial cells were successfully induced from the iPS cells by the stromal cell-derived inducing activity (SDIA differentiation method, as Pax6(+/K12(+ corneal epithelial colonies were observed after prolonged differentiation culture (12 weeks or later in both the L1B41 and 253G1 iPS cells following retinal pigment epithelial and lens cell induction. Interestingly, the corneal epithelial differentiation efficiency was higher in L1B41 than in 253G1. DNA methylation analysis revealed that a small proportion of differentially methylated regions still existed between L1B41 and 253G1 iPS cells even though no significant difference in methylation status was detected in the specific corneal epithelium-related genes such as K12, K3, and Pax6. The present study is the first to demonstrate a strategy for corneal epithelial cell differentiation from human iPS cells, and further suggests that the epigenomic status is associated with the propensity of iPS cells to differentiate into corneal epithelial cells.

  9. Inflammatory cytokine TNF-α promotes corneal endothelium apoptosis via upregulating TIPE2 transcription during corneal graft rejection. (United States)

    Wang, Qun; Wei, Chao; Ma, Li; Wang, Xin; Li, Lin; Zhou, Qingjun; Shi, Weiyun


    Endothelial dysfunction accounts for 50% of total corneal transplantation failures, suggesting that corneal endothelial damage is the leading cause of graft failure. Tumor necrosis factor-α (TNF-α) is known to contribute to the negative regulation of corneal transplantation, but how it does so remains unclear. Here, we report a regulatory loop involving TNF-α, TNF-α-induced protein 8 like 2 (TNFAIP8L2 or TIPE2), and apoptosis during corneal graft rejection. We established mice models of penetrating keratoplasty to verify whether the quantification of TNF-α in allogeneic corneas is enhanced through ELISA assay and immunofluorescence staining. In cornea tissues, we obtained corneal endothelium and measured apoptosis of the removed cells. Meanwhile, quantitative real-time PCR and Western blotting were used to detect the mRNA and protein expression of TIPE2. In human corneal endothelial cells, we verified the conclusions through some experiments. By specifically knocking down TIPE2, we detected the importance of TIPE2 in TNF-α-triggered apoptosis. In mice models, TNF-α was higher in the cornea and aqueous humor in allograft group and TNF-α elevation increased the apoptosis of the corneal endothelium. In addition, high levels of TIPE2 were found in allograft rejection models following TNF-α elevation. In human corneal endothelial cells (HCECs), TNF-α clearly augments TIPE2 expression and promotes cell apoptosis through upregulating TIPE2 transcription. Knocking down markedly decreased cell apoptosis. Our study identifies the molecular mechanisms underlying the interplay of TNF-α, TIPE2, and apoptosis during allograft rejection, and it suggests that both TNF-α and TIPE2 might be potential targets for the successfully grafted corneal endothelium.

  10. Almost ring theory

    CERN Document Server


    This book develops thorough and complete foundations for the method of almost etale extensions, which is at the basis of Faltings' approach to p-adic Hodge theory. The central notion is that of an "almost ring". Almost rings are the commutative unitary monoids in a tensor category obtained as a quotient V-Mod/S of the category V-Mod of modules over a fixed ring V; the subcategory S consists of all modules annihilated by a fixed ideal m of V, satisfying certain natural conditions. The reader is assumed to be familiar with general categorical notions, some basic commutative algebra and some advanced homological algebra (derived categories, simplicial methods). Apart from these general prerequisites, the text is as self-contained as possible. One novel feature of the book - compared with Faltings' earlier treatment - is the systematic exploitation of the cotangent complex, especially for the study of deformations of almost algebras.

  11. Decay ring design

    CERN Document Server

    Chancé, A; Bouquerel, E; Hancock, S; Jensen, E

    The study of the neutrino oscillation between its different flavours needs pureand very intense fluxes of high energy, well collimated neutrinos with a welldetermined energy spectrum. A dedicated machine seems to be necessarynowadays to reach the required flux. A new concept based on the β-decayof radioactive ions which were accelerated in an accelerator chain was thenproposed. After ion production, stripping, bunching and acceleration, the unstableions are then stored in a racetrack-shaped superconducting decay ring.Finally, the ions are accumulated in the decay ring until being lost. The incomingbeam is merged to the stored beam by using a specific RF system, whichwill be presented here.We propose here to study some aspects of the decay ring, such as its opticalproperties, its RF system or the management of the losses which occur in thering (mainly by decay or by collimation).

  12. Corneal sensation in scleritis and episcleritis. (United States)

    Lyne, A. J.


    A series of 59 patients were examined for loss of corneal sensitivity. Thirty-five of them suffered from scleritis and 24 suffered from episcleritis. There was a difference between the 2 conditions in that significantly more patients with scleritis were affected than patients with episcleritis. It was also found that among the scleritis patients there was a close relationship between the number of quadrants affected and decrease in sensitivity. Five patients had necrotising scleritis, and they all showed marked loss of sensitivity. Sensitivity returned to normal when the scleritis resolved except when a large area of scleral ectasia resulted. The test is of importance because it is one of the easiest methods of detecting the onset of necrotising scleritis in its earliest stages. Images PMID:588518

  13. Morphological evaluation of normal human corneal epithelium.

    DEFF Research Database (Denmark)

    Ehlers, Niels; Heegaard, Steffen; Hjortdal, Jesper Østergaard


    of corneas from 100 consecutively selected paraffin-embedded eyes were stained with hematoxylin-eosin and Periodic Acid-Schiff (PAS). All specimens were evaluated by light microscopy. The eyes were enucleated from patients with choroidal melanoma. Corneas were considered to be normal. RESULTS: Ninety of 100...... eyes were evaluated. The central epithelial, stromal and total corneal thickness was measured as 36.0 µm, 618 µm and 651µm, respectively, with a variation coefficient from 0.21 to 0.22. Pathological appearances were found in 27% of corneas, including thickened basement membrane and alterations....... The high number of pathological observations suggests that 'normal' eyes harbour and potentially accumulate considerable pathology....

  14. Another Risk From Cigarette Smoking: Corneal Burn

    Directory of Open Access Journals (Sweden)

    Volkan Hürmeriç


    Full Text Available A 21-year-old male presented with corneal injury in his left eye after one of his friends had moved his arm backwards and accidentally hit his eye with the lit end of a cigarette. Slit lamp examination revealed epithelial defect and significant stromal edema at the superior temporal quadrant of the cornea. Cigarette ashes were noted in his lashes and inferior conjunctival fornix at the initial examination in the emergency service. 6 weeks after the injury, slit lamp examination revealed stromal thinning and haze in the temporal part of the cornea. His best spectacle-corrected distance visual acuity was 20/25 with a refractive error of -6.75x135 diopters in the left eye. Our case demonstrates that ocular thermal injury due to cigarette smoking can cause serious damage to the ocular tissues. (Turk J Oph thal mol 2012; 42: 484-5

  15. Higher-order aberrations after corneal collagen crosslinking for keratoconus and corneal ectasia. (United States)

    Greenstein, Steven A; Fry, Kristen L; Hersh, Matthew J; Hersh, Peter S


    To determine changes in higher-order aberrations (HOAs) after corneal collagen crosslinking (CXL). Cornea and refractive surgery practice. Prospective randomized controlled clinical trial. Corneal and ocular HOAs were measured and analyzed using the Pentacam device and Ladarwave aberrometer, respectively, at baseline and 12 months after CXL. Ninety-six eyes (64 keratoconus, 32 ectasia) of 73 patients had CXL. A fellow-eye control group comprised 42 eyes. The mean preoperative total anterior corneal HOAs, total coma, 3rd-order coma, and vertical coma were 4.68 μm ± 2.33 (SD), 4.40 ± 2.32 μm, 4.36 ± 2.30 μm, and 4.04 ± 2.27 μm, respectively. At 1 year, the mean values decreased significantly to 4.27 ± 2.25 μm, 4.01 ± 2.29 μm, 3.96 ± 2.27 μm, and 3.66 ± 2.22 μm, respectively (all Pcorneal HOAs. The mean preoperative total ocular HOAs, total coma, 3rd-order coma, trefoil, and spherical aberration were 2.80 ± 1.0 μm, 2.60 ± 1.03 μm, 2.57 ± 1.03 μm, 0.98 ± 0.46 μm, and 0.90 ± 0.42 μm, respectively. At 1 year, the mean values decreased significantly to 2.59 ± 1.06 μm, 2.42 ± 1.07 μm, 2.39 ± 1.07 μm, 0.88 ± 0.49 μm, and 0.83 ± 0.38 μm, respectively (all P=.01). After CXL, HOAs were significantly improved compared with the control group. Changes in HOAs were not statistically associated with an improvement in visual acuity or most subjective visual symptoms, however. Corneal and ocular HOAs decreased after CXL, suggesting an improvement in corneal shape. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Stereoacuity after small aperture corneal inlay implantation

    Directory of Open Access Journals (Sweden)

    Linn SH


    Full Text Available Steven H Linn,1 David F Skanchy,2 Tyler S Quist,3 Jordan D Desautels,4 Majid Moshirfar1,5 1Department of Clinical Research, HDR Research Center, Hoopes Vision, Draper, UT, 2McGovern Medical School, The University of Texas Health Science Center at Houston, TX, 3University of Utah School of Medicine, Salt Lake City, UT, 4Tufts University School of Medicine, Boston, MA, 5John A Moran Eye Center, Department of Ophthalmology and Visual Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA Purpose: The aim of this study was to compare stereoacuity before and after KAMRA corneal inlay implantation for the correction of presbyopia.Patients and methods: This is a prospective study of 60 patients who underwent KAMRA inlay implantation. Patients were examined before and 6 months after surgery for stereoacuity, uncorrected distance visual acuity (UDVA, and uncorrected near visual acuity (UNVA.Results: The mean stereoacuity before surgery was 29.5±28.1 arcsec (range: 20–200 and at 6 months was 29.8±26.4 arcsec (range: 20–200. The decline in stereoacuity was not statistically significant. At 6 months follow-up, UDVA was 20/25 or better in all 60 patients and UNVA was J2 (20/25 or better in 51 (85% patients.Conclusion: There is no significant change in stereoacuity following KAMRA inlay implantation. The KAMRA inlay is a good treatment option for improving near vision in presbyopic patients while preserving stereoacuity and distance vision. Keywords: KAMRA, corneal inlay, AcuFocus, stereoacuity, presbyopia 

  17. Clinical utility of the KAMRA corneal inlay

    Directory of Open Access Journals (Sweden)

    Naroo SA


    Full Text Available Shehzad Anjam Naroo, Paramdeep Singh Bilkhu Ophthalmic Research Group, School of Life & Health Sciences, Aston University, Birmingham, UK Abstract: The treatment of presbyopia has been the focus of much scientific and clinical research over recent years, not least due to an increasingly aging population but also the desire for spectacle independence. Many lens and nonlens-based approaches have been investigated, and with advances in biomaterials and improved surgical methods, removable corneal inlays have been developed. One such development is the KAMRA™ inlay where a small entrance pupil is exploited to create a pinhole-type effect that increases the depth of focus and enables improvement in near visual acuity. Short- and long-term clinical studies have all reported significant improvement in near and intermediate vision compared to preoperative measures following monocular implantation (nondominant eye, with a large proportion of patients achieving Jaeger (J 2 to J1 (~0.00 logMAR to ~0.10 logMAR at the final follow-up. Although distance acuity is reduced slightly in the treated eye, binocular visual acuity and function remain very good (mean 0.10 logMAR or better. The safety of the inlay is well established and easily removable, and although some patients have developed corneal changes, these are clinically insignificant and the incidence appears to reduce markedly with advancements in KAMRA design, implantation technique, and femtosecond laser technology. This review aims to summarize the currently published peer-reviewed studies on the safety and efficacy of the KAMRA inlay and discusses the surgical and clinical outcomes with respect to the patient’s visual function. Keywords: presbyopia, refractive surgery, implants, cornea

  18. Tear Mediators in Corneal Ectatic Disorders.

    Directory of Open Access Journals (Sweden)

    Dorottya Pásztor

    Full Text Available To compare the concentrations of 11 tear mediators in order to reveal the biochemical difference between pellucid marginal degeneration (PMD and keratoconus (KC.We have designed a cross-sectional study in which patients with corneal ectasia based on slit-lamp biomicroscopy and Pentacam HR (keratometry values (K1, K2, Kmax, astigmatism, minimal radius of curvature (Rmin, corneal thickness (Apex and Min, indices (surface variation, vertical asymmetry, keratoconus, central keratoconus, height asymmetry and decentration were enrolled. Eyes of keratoconic patients were similar to the PMD patients in age and severity (K2, Kmax and Rmin. Non-stimulated tear samples were collected from nine eyes of seven PMD patients, 55 eyes of 55 KC patients and 24 eyes of 24 healthy controls. The mediators' (interleukin -6, -10, chemokine ligand 5, -8, -10, matrix metalloproteinase (MMP -9, -13, tissue inhibitor of metalloproteinases (TIMP-1, tissue plasminogen activator, plasminogen activator inhibitor, nerve growth factor concentrations were measured using Cytometric Bead Array.MMP-9 was the only mediator which presented relevant variances between the two patient groups (p = 0.005. The ratios of MMP-9 and TIMP-1 were 2.45, 0.40 and 0.23 in PMD, KC and the controls, respectively.As far as we are aware, this is the first study that aims to reveal the biochemical differences between PMD and KC. Further studies of biomarkers to investigate the precise role of these mediators need to be defined, and it is important to confirm the observed changes in a larger study to gain further insights into the molecular alterations in PMD.

  19. Comparison of scleral and corneal Tono-Pen readings. (United States)

    Kolin, Talia; Wedemeyer, Linda L; Kolin, Elliot; Braun, Yosi


    To compare scleral Tono-Pen (Medtronic Solan, Jacksonville, FL) readings to corneal Tono-Pen readings. Intraocular pressure (IOP) was measured prospectively in 72 eyes of 37 adult patients and in 10 eyes of 5 children. Measurements were taken on the central cornea and on the sclera. Recorded measurements were within 5% confidence levels by Tono-Pen. Corneal IOP ranged from 10 to 28 mm Hg (mean +/- standard deviation, 17.0 +/- 3.8 mm Hg). Scleral measurements ranged from 4 to 99 mm Hg (40.4 +/- 23.0 mm Hg). Scleral measurements ranged from 11 mm Hg lower to 76 mm Hg higher than corneal measurements. Tono-Pen readings obtained from sclera are of no clinical value and should not be used to approximate corneal IOP.

  20. Corneal epithelium and UV-protection of the eye. (United States)

    Ringvold, A


    To study UV-absorption and UV-induced fluorescence in the bovine corneal epithelium. Spectrophotometry and spectrofluorimetry. The corneal epithelium absorbs UV-B radiation mainly owing to its content of protein, RNA, and ascorbate. Some of the absorbed energy is transformed to the less biotoxic UV-A radiation by fluorescence. RNA and ascorbate reduce tissue fluorescence. The corneal epithelium acts as a UV-filter, protecting internal eye structures through three different mechanisms: (1) Absorption of UV-B roughly below 310 nm wavelength. (2) Fluorescence-mediated ray transformation to longer wavelengths. (3) Fluorescence reduction. The extremely high ascorbate concentration in the corneal epithelium has a key role in two of these processes.

  1. Excimer laser corneal surgery and free oxygen radicals. (United States)

    Bilgihan, K; Bilgihan, A; Akata, F; Hasanreisoğlu, B; Türközkan, N


    Corneal photoablation with 193 nm argon fluoride excimer laser is a new technique for the treatment of refractive errors and for removing corneal opacities and irregularities. Ultraviolet radiation and thermal injury induce free radical formation in the tissues. The aim of this study was to confirm the production of free radicals by excimer laser photoablation in rabbits. The thermal changes of the posterior corneal surface were recorded during excimer laser photoablation. The lipid peroxide (LPO) levels and superoxide dismutase (SOD) activities of aqueous humour were measured after excimer laser keratectomy. The aqueous LPO levels were not changed after excimer laser ablation, but both the thermal increase in the cornea during the photoablation and the decreased aqueous SOD activities suggest that free radicals are formed in the cornea during excimer laser keratectomy, and that they may be responsible for some of the complications of excimer laser corneal surgery.

  2. Corneal ulcers: For the general practitioner | Ballim | Continuing ...

    African Journals Online (AJOL)

    Abstract. A corneal ulcer is a defect in the epithelial layer of the cornea. e general practitioner may play an important role in early management and appropriate referral. Incidence varies and depends on aetiology.

  3. Restoration of Corneal Transparency by Mesenchymal Stem Cells

    Directory of Open Access Journals (Sweden)

    Sharad K. Mittal


    Full Text Available Transparency of the cornea is indispensable for optimal vision. Ocular trauma is a leading cause of corneal opacity, leading to 25 million cases of blindness annually. Recently, mesenchymal stem cells (MSCs have gained prominence due to their inflammation-suppressing and tissue repair functions. Here, we investigate the potential of MSCs to restore corneal transparency following ocular injury. Using an in vivo mouse model of ocular injury, we report that MSCs have the capacity to restore corneal transparency by secreting high levels of hepatocyte growth factor (HGF. Interestingly, our data also show that HGF alone can restore corneal transparency, an observation that has translational implications for the development of HGF-based therapy.

  4. Cataract Surgery with a Refractive Corneal Inlay in Place


    Stojanovic, N. R.; Panagopoulou, S. I.; Pallikaris, I. G.


    Purpose. To present a case of cataract surgery performed in a patient with a refractive corneal inlay in place. Methods. A 48-year-old female patient presented to our institute with bilateral cataract. The patient had undergone refractive corneal inlay implantation three years ago in her right, nondominant eye for presbyopia correction. Biometry and intraocular lens (IOL) power calculation were performed without removing the inlay. Phacoemulsification and IOL insertion were carried out in bot...

  5. [Diagnostic value of confocal microscopy in primary corneal ectasia]. (United States)

    Egorova, G B; Rogova, A Ia; Mitichkina, T S


    Diagnostic value of confocal microscopy in subclinical corneal ectasia is analysed. Morphological changes were revealed in 71.2% of cases with subclinical keratoconus. Results of the study let us reveal typical morphological abnormalities in subclinical keratoconus, although these changes are not specific for this condition. The method is also not informative for detecting of early signs of pellucid marginal degeneration. Confocal microscopy may be considered an additional specifying method in diagnostic algorithm of subclinical corneal ectasia.

  6. [The use of iontophoresis in corneal crosslinking technique]. (United States)

    Stanca, Horia T; Tabacaru, Bogdana


    Iontophoresis is a method of facilitating the penetration of a drug through an intact tissue in the presence of an low intensity electrical current. In corneal crosslinking technique, iontophoresis is used for transepitelial impregnation of cornea with riboflavin. Compared to passive technique of corneal impregnation, iontophoresis shortens the time needed for impregnation, the time of exposure to UVA radiation and does not require de-epithelialisation.

  7. Serum zinc in corneal ulcer-A preliminary report

    Directory of Open Access Journals (Sweden)

    Pati Santanu


    Full Text Available In recent times zinc is emerging as a nutrient of clinical importance and had been found to be low in serum in various disease conditions. In the current study 11 control cases and 22 corneal ulcer cases were taken. Their serum zinc level was measured by atomic absorption spectrophotometer. Serum zinc level in recalcitrant corneal ulcer cases was found to be below normal.

  8. Fusion rings and fusion ideals

    DEFF Research Database (Denmark)

    Andersen, Troels Bak

    This dissertation investigates fusion rings, which are Grothendieck groups of rigid, monoidal, semisimple, abelian categories. Special interest is in rational fusion rings, i.e., fusion rings which admit a finite basis, for as commutative rings they may be presented as quotients of polynomial rings...... by the so-called fusion ideals. The fusion rings of Wess-Zumino-Witten models have been widely studied and are well understood in terms of precise combinatorial descriptions and explicit generating sets of the fusion ideals. They also appear in another, more general, setting via tilting modules for quantum...

  9. Fusion Rings for Quantum Groups

    DEFF Research Database (Denmark)

    Andersen, Henning Haahr; Stroppel, Catharina


    We study the fusion rings of tilting modules for a quantum group at a root of unity modulo the tensor ideal of negligible tilting modules. We identify them in type A with the combinatorial rings from [12] and give a similar description of the sp2n-fusion ring in terms of noncommutative symmetric...... functions. Moreover we give a presentation of all fusion rings in classical types as quotients of polynomial rings. Finally we also compute the fu- sion rings for type G2....

  10. Lattices for antiproton rings

    International Nuclear Information System (INIS)

    Autin, B.


    After a description of the constraints imposed by the cooling of Antiprotons on the lattice of the rings, the reasons which motivate the shape and the structure of these machines are surveyed. Linear and non-linear beam optics properties are treated with a special amplification to the Antiproton Accumulator. (orig.)

  11. Flushing Ring for EDM (United States)

    Earwood, L.


    Removing debris more quickly lowers cutting time. Operation, cutting oil and pressurized air supplied to ring placed around workpiece. Air forces oil through small holes and agitates oil as it flows over workpiece. High flow rate and agitation dislodge and remove debris. Electrical discharge removes material from workpiece faster.

  12. SXLS storage ring design

    International Nuclear Information System (INIS)



    X-ray lithography has emerged as a strong candidate to meet the demands of ever finer linewidths on integrated circuits, particularly for linewidths less than .25 microns. Proximity printing X-ray lithography makes use of soft X-rays to shadow print an image of a mask onto a semiconductor wafer to produce integrated circuits. To generate the required X-rays in sufficient quantities to make commercial production viable, electron storage rings have been proposed as the soft X-ray sources. Existing storage rings have been used to do the initial development work and the success of these efforts has led the lithographers to request that new rings be constructed that are dedicated to X-ray lithography. As a result of a series of workshops held at BNL [10.3] which were attended by both semiconductor and accelerator scientists, the following set of zeroth order specifications' on the light and electron beam of a storage ring for X-ray lithography were developed: critical wavelength of light: λ c = 6 to 10 angstroms, white light power: P = 0.25 to 2.5 watts/mrad, horizontal collection angle per port: θ = 10 to 50 mrad, electron beam sizes: σ x ∼ σ y y ' < 1 mrad

  13. Decreased corneal sensation as an initial feature of Acanthamoeba keratitis. (United States)

    Perry, H D; Donnenfeld, E D; Foulks, G N; Moadel, K; Kanellopoulos, A J


    Herpes simplex keratitis is the most common misdiagnosis in patients with Acanthamoeba keratitis, which is increasing in frequency and is associated with daily wear soft contact lenses. Both entities usually present as unilateral keratitis. The manifestations of superficial Acanthamoeba keratitis (i.e., unilaterality, dendriform appearance, positive response to antivirals, and decreased corneal sensation) increase the opportunity for misdiagnosis as herpes simplex keratitis. The authors have encountered six patients with Acanthamoeba keratitis in whom the correct diagnosis was delayed from 2 weeks to 3 months. All six patients underwent testing with the Cochet-Bonnet esthesiometer and extensive pharmacologic treatment for herpes simplex keratitis. Corneal scrapings were taken between 2 and 6 weeks after the initial examination. In all six patients, corneal sensation was decreased significantly. Drug therapy was ineffective. Cultures were positive for Acanthamoeba. Five of six patients underwent penetrating keratoplasty. Decreased corneal sensation has contributed to the misdiagnosis of Acanthamoeba as herpes simplex keratitis. Misdiagnosis results in delayed treatment and worse outcome. The authors found that significantly decreased corneal sensation is a frequent finding in early Acanthamoeba keratitis. Therefore, physicians should consider Acanthamoeba keratitis as an alternative diagnosis in patients with presumed herpes simplex keratitis with decreased corneal sensation.

  14. Congenital Corneal Anesthesia and Neurotrophic Keratitis: Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Flavio Mantelli


    Full Text Available Neurotrophic keratitis (NK is a rare degenerative disease of the cornea caused by an impairment of corneal sensory innervation, characterized by decreased or absent corneal sensitivity resulting in epithelial keratopathy, ulceration, and perforation. The aetiopathogenesis of corneal sensory innervation impairment in children recognizes the same range of causes as adults, although they are much less frequent in the pediatric population. Some extremely rare congenital diseases could be considered in the aetiopathogenesis of NK in children. Congenital corneal anesthesia is an extremely rare condition that carries considerable diagnostic and therapeutic problems. Typically the onset is up to 3 years of age and the cornea may be affected in isolation or the sensory deficit may exist as a component of a congenital syndrome, or it may be associated with systemic somatic anomalies. Accurate diagnosis and recognition of risk factors is important for lessening long-term sequelae of this condition. Treatment should include frequent topical lubrication and bandage corneal or scleral contact lenses. Surgery may be needed in refractory cases. The purpose of this review is to summarize and update data available on congenital causes and treatment of corneal hypo/anesthesia and, in turn, on congenital NK.

  15. Effects of two different incision phacoemulsification on corneal astigmatism

    Directory of Open Access Journals (Sweden)

    Lu Huo


    Full Text Available AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. METHODS: Totally 88 cases(122 eyeswith pure cataract were randomly divided into two groups. Forty cases(60 eyeswere clarity corneal incision in group A, and 48 cases(62 eyeswere sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA, uncorrected visual acuity(UCVAand best correct vision acuity(BCVAwere observed in pre- and post-operation at 1d; 1wk; 1mo.RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(PPP>0.05. UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(PP>0.05.CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOLimplantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.

  16. Keratoconus Detection Based on a New Corneal Volumetric Analysis. (United States)

    Cavas-Martínez, Francisco; Bataille, Laurent; Fernández-Pacheco, Daniel G; Cañavate, Francisco J F; Alio, Jorge L


    There are numerous tomographic indices for the detection of keratoconus risk. When the indexes based on corneal volume are analyzed, two problems are presented: on the one hand, they are not very sensitive to the detection of incipient cases of keratoconus because they are not locally defined in the primary developmental region of the structural abnormalities; and on the other hand, they do not register the geometric decompensation driven by the asymmetry present during the disease progression. This work performed a morphogeometric modeling of the cornea by the aid of CAD tools and using raw topographic data (Sirius system, CSO, Firenze). For this method, four singular points present on the corneal surfaces were located and the following parameters based on corneal volume were calculated: VOL mct , defined by the points of minimal thickness; VOL aap , defined by the anterior corneal apex, and VOL pap , defined by the posterior corneal apex. The results demonstrate that a further reduction of corneal volume in keratoconus happens and significantly progresses along the disease severity level. The combination of optical and volumetric data, that collect the sensitivity of the asymmetry generated by the disease, allows an accurate detection of incipient cases and follow up of the disease progression.

  17. Inhibition of Corneal Neovascularization by Topical and Subconjunctival Tigecycline

    Directory of Open Access Journals (Sweden)

    Sertan Goktas


    Full Text Available Objective. To investigate the effects of topical and subconjunctival tigecycline on the prevention of corneal neovascularization. Materials and Methods. Following chemical burn, thirty-two rats were treated daily with topical instillation of 1 mg/mL tigecycline (group 1 or subconjunctival instillation of 1 mg/mL tigecycline (group 3 for 7 days. Control rats received topical (group 2 or subconjunctival (group 4 0.9% saline. Digital photographs of the cornea were taken on the eighth day after treatment and analyzed to determine the percentage area of the cornea covered by neovascularization. Corneal sections were analyzed histopathologically. Results. The median percentages of corneal neovascularization in groups 1 and 3 were 48% (95% confidence interval (CI, 44.2–55.8% and 33.5% (95% CI, 26.6–39.2%, respectively. The median percentages of corneal neovascularization of groups 1 and 3 were significantly lower than that of the control group (P=0.03 and P<0.001, resp.. Histologic examination of samples from groups 1 and 3 showed lower vascularity than that of control groups. Conclusion. Topical and subconjunctival administration of tigecycline seems to be showing promising therapeutic effects on the prevention of corneal neovascularization. Furthermore, subconjunctival administration of tigecycline is more potent than topical administration in the inhibition of corneal neovascularization.

  18. Acacia honey accelerates in vitro corneal ulcer wound healing model. (United States)

    Abd Ghafar, Norzana; Ker-Woon, Choy; Hui, Chua Kien; Mohd Yusof, Yasmin Anum; Wan Ngah, Wan Zurinah


    The study aimed to evaluate the effects of Acacia honey (AH) on the migration, differentiation and healing properties of the cultured rabbit corneal fibroblasts. Stromal derived corneal fibroblasts from New Zealand White rabbit (n = 6) were isolated and cultured until passage 1. In vitro corneal ulcer was created using a 4 mm corneal trephine onto confluent cultures and treated with basal medium (FD), medium containing serum (FDS), with and without 0.025 % AH. Wound areas were recorded at day 0, 3 and 6 post wound creation. Genes and proteins associated with wound healing and differentiation such as aldehyde dehydrogenase (ALDH), vimentin, alpha-smooth muscle actin (α-SMA), collagen type I, lumican and matrix metalloproteinase 12 (MMP12) were evaluated using qRT-PCR and immunocytochemistry respectively. Cells cultured with AH-enriched FDS media achieved complete wound closure at day 6 post wound creation. The cells cultured in AH-enriched FDS media increased the expression of vimentin, collagen type I and lumican genes and decreased the ALDH, α-SMA and MMP12 gene expressions. Protein expression of ALDH, vimentin and α-SMA were in accordance with the gene expression analyses. These results demonstrated AH accelerate corneal fibroblasts migration and differentiation of the in vitro corneal ulcer model while increasing the genes and proteins associated with stromal wound healing.

  19. Ring Bubbles of Dolphins (United States)

    Shariff, Karim; Marten, Ken; Psarakos, Suchi; White, Don J.; Merriam, Marshal (Technical Monitor)


    The article discusses how dolphins create and play with three types of air-filled vortices. The underlying physics is discussed. Photographs and sketches illustrating the dolphin's actions and physics are presented. The dolphins engage in this behavior on their own initiative without food reward. These behaviors are done repeatedly and with singleminded effort. The first type is the ejection of bubbles which, after some practice on the part of the dolphin, turn into toroidal vortex ring bubbles by the mechanism of baroclinic torque. These bubbles grow in radius and become thinner as they rise vertically to the surface. One dolphin would blow two in succession and guide them to fuse into one. Physicists call this a vortex reconnection. In the second type, the dolphins first create an invisible vortex ring in the water by swimming on their side and waving their tail fin (also called flukes) vigorously. This vortex ring travels horizontally in the water. The dolphin then turns around, finds the vortex and injects a stream of air into it from its blowhole. The air "fills-out" the core of the vortex ring. Often, the dolphin would knock-off a smaller ring bubble from the larger ring (this also involves vortex reconnection) and steer the smaller ring around the tank. One other dolphin employed a few other techniques for planting air into the fluke vortex. One technique included standing vertically in the water with tail-up, head-down and tail piercing the free surface. As the fluke is waved to create the vortex ring, air is entrained from above the surface. Another technique was gulping air in the mouth, diving down, releasing air bubbles from the mouth and curling them into a ring when they rose to the level of the fluke. In the third type, demonstrated by only one dolphin, the longitudinal vortex created by the dorsal fin on the back is used to produce 10-15 foot long helical bubbles. In one technique she swims in a curved path. This creates a dorsal fin vortex since

  20. Corneal Cross-linking to Halt the Progression of Keratoconus and Corneal Ectasia: Seven-Year Follow-up. (United States)

    O'Brart, David P S; Patel, Parul; Lascaratos, Gerassimos; Wagh, Vijay K; Tam, Connan; Lee, Jennifer; O'Brart, Naomi A


    To determine long-term efficacy and safety of riboflavin/ultraviolet A corneal cross-linking (CXL). Prospective cohort study. Thirty-six patients (36 eyes) who underwent epithelium-off CXL at a University Hospital (Guy's and St Thomas' National Health Service Foundation Trust) 6-8 years previously were examined. The main outcome measures were refractive error, visual acuity, corneal topographic keratometry, ultrasonic pachymetry, and topography-derived corneal wavefront. At 7 years compared to preoperative values, mean spherical equivalent refractive error (SEQ) increased by +0.78 diopter (D) (P corneal cross-linking, improvements in topographic and wavefront parameters evident at 1 year were seen to continue to improve at 5 years and were maintained at 7 years. No treated eyes progressed over the 7-year follow-up period. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Evaluation of subbasal nerve morphology and corneal sensation after accelerated corneal collagen cross-linking treatment on keratoconus. (United States)

    Ozgurhan, Engin Bilge; Celik, Ugur; Bozkurt, Ercument; Demirok, Ahmet


    The aim of this study was to report on the evaluation of corneal nerve fiber density and corneal sensation after accelerated corneal collagen cross-linking on keratoconus patients. The study was performed on 30 keratoconus eyes (30 participants: 16 M, 14 F; 17-32 years old) treated with accelerated collagen cross-linking for disease stabilization. Mean outcome measures were corneal sensation evaluation by Cochet-Bonnet esthesiometry and subbasal nerve fiber density assessment by corneal in vivo confocal microscopy. All corneal measurements were performed using scanning slit confocal microscopy (ConfoScan 4, Nidek Technologies, Padova, Italy). The accelerated corneal collagen cross-linking procedure was performed on 30 eyes of 30 patients (19 right, 63.3%; 11 left, 27.7%). The mean age was 23.93 ± 4. The preoperative mean keratometry, apex keratometry and pachymetry values were 47.19 ± 2.82 D, 56.79 ± 5.39 and 426.1 ± 25.6 μm, respectively. Preoperative mean corneal sensation was 56.3 ± 5.4 mm (with a range from 40 to 60 mm), it was significantly decreased at 1st and 3rd month visit and increased to preoperative values after 6th month visit. Preoperative mean of subbasal nerve fiber density measurements was 22.8 ± 9.7 nerve fiber/mm(2) (with a range of 5-45 mm), it was not still at the preoperative values at 6th month (p = 0.0001), however reached to the preoperative values at 12th month (p = 0.914). Subbasal nerve fibers could reach the preoperative values at the 12th month after accelerated corneal collagen cross-linking treatment although the corneal sensation was improved at 6th month. These findings imply that the subjective healing process is faster than the objective evaluation of the keratoconus patients' cornea treated with accelerated corneal collagen cross-linking.


    Directory of Open Access Journals (Sweden)

    Karyati Karyati


      One of algebraic structure that involves a binary operation is a group that is defined  an un empty set (classical with an associative binary operation, it has identity elements and each element has an inverse. In the structure of the group known as the term subgroup, normal subgroup, subgroup and factor group homomorphism and its properties. Classical algebraic structure is developed to algebraic structure fuzzy by the researchers as an example semi group fuzzy and fuzzy group after fuzzy sets is introduced by L. A. Zadeh at 1965. It is inspired of writing about semi group fuzzy and group of fuzzy, a research on the algebraic structure of the ring is held with reviewing ring fuzzy, ideal ring fuzzy, homomorphism ring fuzzy and quotient ring fuzzy with its properties. The results of this study are obtained fuzzy properties of the ring, ring ideal properties fuzzy, properties of fuzzy ring homomorphism and properties of fuzzy quotient ring by utilizing a subset of a subset level  and strong level  as well as image and pre-image homomorphism fuzzy ring.   Keywords: fuzzy ring, subset level, homomorphism fuzzy ring, fuzzy quotient ring

  3. Construction of Anterior Hemi-Corneal Equivalents Using Nontransfected Human Corneal Cells and Transplantation in Dog Models. (United States)

    Xu, Bin; Song, Zhan; Fan, Tingjun


    Tissue-engineered human anterior hemi-cornea (TE-aHC) is a promising equivalent for treating anterior lamellar keratopathy to surmount the severe shortage of donated corneas. This study was intended to construct a functional TE-aHC with nontransfected human corneal stromal (ntHCS) and epithelial (ntHCEP) cells using acellular porcine corneal stromata (aPCS) as a carrier scaffold, and evaluate its biological functions in a dog model. To construct a TE-aHC, ntHCS cells were injected into an aPCS scaffold and cultured for 3 days; then, ntHCEP cells were inoculated onto the Bowman's membrane of the scaffold and cultured for 5 days under air-liquid interface condition. After its morphology and histological structure were characterized, the constructed TE-aHC was transplanted into dog eyes via lamellar keratoplasty. The corneal transparency, thickness, intraocular pressure, epithelial integrity, and corneal regeneration were monitored in vivo, and the histological structure and histochemical property were examined ex vivo 360 days after surgery, respectively. The results showed that the constructed TE-aHC was highly transparent and composed of a corneal epithelium of 7-8 layer ntHCEP cells and a corneal stroma of regularly aligned collagen fibers and well-preserved glycosaminoglycans with sparsely distributed ntHCS cells, mimicking a normal anterior hemi-cornea (aHC). Moreover, both ntHCEP and ntHCS cells maintained positive expression of their marker and functional proteins. After transplantation into dog eyes, the constructed TE-aHC acted naturally in terms of morphology, structure and inherent property, and functioned well in maintaining corneal clarity, thickness, normal histological structure, and composition in dog models by reconstructing a normal aHC, which could be used as a promising aHC equivalent in corneal regenerative medicine and aHC disorder therapy. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Explore the full thick layer of corneal transplantation in the treatment of pseudomonas aeruginosa corneal ulcer infection

    Directory of Open Access Journals (Sweden)

    Xin Wang


    Full Text Available AIM: To explore the feasibility, safety and effect of the full-thickness lamellar keratoplasty for the treatment of pseudomonas aeruginosa corneal ulcer. METHODS: Based on a retrospective non-controlled study, 25 patients were given the full-thickness lamellar keratoplasty for clinical diagnosis of pseudomonas aeruginosa infection and corneal ulcer medication conventional anti-gram-negative bacteria. Routine follow-up were carried out at postoperative 1wk; 1, 3, 6, 12, 18mo to observe the situation of corneal epithelial healing, recurrent infection, immune rejection, graft transparency and best corrected visual acuity, etc. At the 6 and 12mo postoperative, corneal endothelial cell density was reexamined.RESULTS: No patients because of Descemet's membrane rupture underwent penetrating keratoplasty surgery: One only in cases of bacterial infection after 1mo, once again did not cultivate a culture of bacteria pseudomonas aeruginosa, and the remaining 24 cases average follow-up 14±6mo, corneal graft were transparent, the cure rate was 96%. At the sixth month after surgery, there were 16 cases of eye surgery best corrected visual acuity ≥4.5, of which 3 cases ≥4.8. At the sixth month after surgery, the average corneal endothelial cell density 2 425±278/mm2; At 12mo postoperatively, it was 2 257± 326/mm2.CONCLUSION: Full-thickness lamellar keratoplasty is an effective method of pseudomonas aeruginosa infection in the treatment of corneal ulcers, corneal drying material glycerol can be achieved by visual effects.

  5. Generation of Femtosecond Laser-Cut Decellularized Corneal Lenticule Using Hypotonic Trypsin-EDTA Solution for Corneal Tissue Engineering


    Huh, Man-Il; Lee, Kyoung-Pil; Kim, Jeongho; Yi, Soojin; Park, Byeong-Ung; Kim, Hong Kyun


    Purpose. To establish an optimized and standardized protocol for the development of optimal scaffold for bioengineering corneal substitutes, we used femtosecond laser to process human corneal tissue into stromal lenticules and studied to find the most efficient decellularization method among various reagents with different tonicities. Methods. The decellularization efficacy of several agents (0.1%, 0.25%, and 0.5% of Triton X-100, SDS, and trypsin-EDTA (TE), resp.) with different tonicities w...

  6. Excimer laser-assisted anterior lamellar keratoplasty for keratoconus, corneal problems after laser in situ keratomileusis, and corneal stromal opacities. (United States)

    Bilgihan, Kamil; Ozdek, Sengül C; Sari, Ayça; Hasanreisoğlu, Berati


    To evaluate excimer laser-assisted anterior lamellar keratoplasty to augment thin corneas as in keratoconus ( .05). This technique presents a different modality for the treatment of keratoconus, post-LASIK corneal problems, and other corneal stromal opacities with anterior lamellar keratoplasty. Additional studies with more patients and longer follow-up will help determine the role of this technique as a substitute for penetrating keratoplasty in these patients.

  7. Resultados del tratamiento con anillos de Ferrara en pacientes con diagnóstico de queratocono Results of the treatment of patients diagnosed with keratoconus using Ferrara rings

    Directory of Open Access Journals (Sweden)

    Judith Cuevas Ruiz


    Full Text Available OBJETIVO: El propósito de este trabajo fue evaluar los resultados del tratamiento con anillos de Ferrara en pacientes con queratocono. MÉTODOS: Se realizó un estudio prospectivo descriptivo en 17 ojos de 12 pacientes de uno y otro sexos con diagnóstico de queratocono, operados con anillos intraestromales de Ferrara, y se evaluó la refracción dinámica y queratometría topográfica preoperatoria y a los 6 meses del posoperatorio de los pacientes, así como las complicaciones detectadas mediante biomicroscopia. Los datos fueron procesados con el uso del paquete profesional estadístico SPSS (Statistical Package for Social Sciences versión 11.5. RESULTADOS: La agudeza visual sin y con corrección mejoró en 70,6 y 82,4 % respectivamente. El componente esférico y el astigmatismo evolucionaron favorablemente en 76,5 % de los pacientes. Las queratometrías en el meridiano fuerte mejoraron en 94,1 y el débil en 70,6 %. Las complicaciones no fueron significativas. Las opacidades perianulares fueron las más frecuentes en 29,4 % de los casos. CONCLUSIONES: El implante de anillos intraestromales de Ferrara constituye una alternativa quirúrgica y terapéutica eficaz para los pacientes portadores de queratocono.OBJECTIVES: This paper was aimed at evaluating the results of the treatment of patients with keratoconus using Ferrara rings. METHODS: A prospective and descriptive study of 17 eyes from 12 patients of both sexes, diagnosed with keratoconus and operated on with intrastromal Ferrara rigs was conducted. Dynamic refraction and topographic keratometry were assessed preoperatively and 6 months after the surgery as well as detected complications were analyzed using biomicroscopy. Data processing used SPSS package (Statistical Package for Social Sciences version 11.5. RESULTS: Visual acuity without and with correction improved in 70.6% and 82.4% of cases respectively. Spheral component and astigmatism positively evolved in 76,5% of patients

  8. Clinical characterization of corneal ectasia after myopic laser in situ keratomileusis based on anterior corneal aberrations and internal astigmatism. (United States)

    Piñero, David P; Alió, Jorge L; Barraquer, Rafael I; Uceda-Montanes, Antonio; Murta, Joaquim


    To evaluate and characterize the clinical features of corneal ectasia after myopic laser in situ keratomileusis (LASIK) considering internal astigmatism and corneal aberrations and their correlation with other clinical data. Vissum-Instituto de Oftalmológico de Alicante, Alicante, Spain. Retrospective comparative case series. In this multicenter study, eyes were divided into 2 groups. The study group comprised eyes that had corneal ectasia after myopic LASIK. The control group comprised eyes that had successful LASIK to correct high myopia. The clinical outcomes were analyzed and compared. Internal astigmatism was calculated using vectorial analysis. The study enrolled 91 eyes (48 study group; 40 control group) of 81 patients (age 18 to 67 years). Uncorrected and corrected (CDVA) distance visual acuities and the refractive status were significantly worse in the study group (P ≤ .01). Corneas in the study group had a significantly higher steepest keratometry (K) reading and a more negative central asphericity (P corneal aberrations were also significantly higher in the study group (P corneal aberrations leading to a visual deterioration were present in eyes with corneal ectasia after myopic LASIK. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Natural history of corneal haze after collagen crosslinking for keratoconus and corneal ectasia: Scheimpflug and biomicroscopic analysis. (United States)

    Greenstein, Steven A; Fry, Kristen L; Bhatt, Jalpa; Hersh, Peter S


    To determine the natural history of collagen crosslinking (CXL)-associated corneal haze measured by Scheimpflug imagery and slitlamp biomicroscopy in patients with keratoconus or ectasia after laser in situ keratomileusis. Cornea and refractive surgery subpecialty practice, United States. Prospective randomized controlled clinical trial. The treatment group received ultraviolet-A/riboflavin CXL therapy. The control group received riboflavin alone without epithelial debridement. To objectively measure CXL-associated corneal haze, corneal densitometry using Scheimpflug imagery was measured and the changes in haze were analyzed over time. A similar analysis was performed using clinician-determined slitlamp haze. Correlation of CXL-associated corneal haze with postoperative outcomes was analyzed. The mean preoperative corneal densitometry was 14.9 ± 1.93 (SD) (Pentacam Scheimpflug densitometry units). Densitometry peaked at 1 month (mean 23.4 ± 4.40; Pectasia group (16.1 ± 2.41; P = .15). The postoperative course of slitlamp haze was similar to objective densitometry measurements. Increased haze, measured by densitometry, did not correlate with postoperative clinical outcomes. The time course of corneal haze after CXL was objectively quantified; it was greatest at 1 month, plateaued at 3 months, and was significantly decreased between 3 months and 12 months. Changes in haze did not correlate with postoperative clinical outcomes. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  10. Inorganic glass ceramic slip rings (United States)

    Glossbrenner, E. W.; Cole, S. R.


    Prototypes of slip rings have been fabricated from ceramic glass, a material which is highly resistant to deterioration due to high temperature. Slip ring assemblies were not structurally damaged by mechanical tests and performed statisfactorily for 200 hours.

  11. Corneal Epithelial Remodeling and Its Effect on Corneal Asphericity after Transepithelial Photorefractive Keratectomy for Myopia

    Directory of Open Access Journals (Sweden)

    Jie Hou


    Full Text Available Purpose. To evaluate the changes in epithelial thickness profile following transepithelial photorefractive keratectomy (T-PRK for myopia and to investigate the effect of epithelial remodeling on corneal asphericity. Methods. Forty-four patients (44 right eyes who underwent T-PRK were retrospectively evaluated. Epithelial thickness was measured using spectral-domain optical coherence tomography at different corneal zones (central, 2 mm; paracentral, 2–5 mm; and mid-peripheral, 5-6 mm preoperatively and at 1 week and 1, 3, and 6 months postoperatively. The correlation between the changes in corneal epithelial thickness (ΔCET and postoperative Q-value changes (ΔQ was analyzed 6 months postoperatively. Results. Epithelial thickness at 6 months showed a negative meniscus-like lenticular pattern with less central thickening, which increased progressively toward the mid-periphery (3.69±4.2, 5.19±3.8, and 6.23±3.9 μm at the center, paracenter, and mid-periphery, resp., P<0.01. A significant positive relationship was observed between epithelial thickening and ΔQ 6 months postoperatively (r=0.438, 0.580, and 0.504, resp., P<0.01. Conclusions. Significant epithelial thickening was observed after T-PRK and showed a lenticular change with more thickening mid-peripherally, resulting in increased oblateness postoperatively. Epithelial remodeling may modify the epithelial thickness profile after surface ablation refractive surgery for myopia.

  12. e-læring

    DEFF Research Database (Denmark)

    Helms, Niels Henrik

    e-læring kan defineres på ganske mange måder. Ordet e-læring består jo tydeligt nok af to elementer. E + læring ligesom e-handel eller e-banking, og umiddelbart vil de fleste nok sige, at det så handler om læring vha. internettet. I bidraget advokeres for en læringsmæssig frem for normativ tilgang....

  13. Design of low energy ring(s)

    CERN Document Server

    Lachaize, Antoine

    During the last two years, several upgrades of the initial baseline scenario were studied with the aim of increasing the average intensity of ion beams in the accelerator chain of the Beta Beam complex. This is the reason why the Rapid Cycling Synchrotron (RCS) specifications were reconsidered many times [1], [2], [3].General considerations on the optical design were presented at the Beta Beam Task Meetings held at CERN and at Saclay in 2005 [4]. More detailed beam optics studies were performed during the next months. Lattices, RF system parameters, multi-turn injection scheme, fast extraction, closed orbit correction and chromaticity correction systems were proposed for different versions of the RCS [5], [6], [7].Finally, the RCS specifications have stabilized in November 2006 after the fourth Beta Beam Task Meeting when it was decided to fix the maximum magnetic rigidity of ion beams to 14.47 T.m (3.5 GeV equivalent proton energy) and to adopt a ring physical radius of 40 m in order to facilitate injectio...

  14. Hemangiossarcoma corneal em cão

    Directory of Open Access Journals (Sweden)

    Ú.C. Guberman


    Full Text Available O hemangiossarcoma é uma neoplasia maligna e sua apresentação corneal é rara em cães. Relata-se um caso de hemangiossarcoma corneal primário, em uma fêmea canina, sem raça definida, de 20kg, nove anos de idade e com histórico de crescimento progressivo de massa em bulbo ocular direito há dois meses. Ao exame oftálmico do olho direito, foram observados blefarospasmo, hiperemia conjuntival moderada e presença de nódulo avermelhado, irregular em região dorsal de córnea direita, ocupando cerca de 60% dela. A ultrassonografia ocular foi realizada, e constatou-se que a neoplasia acometia apenas a córnea. Por meio do exame citológico, foi diagnosticada neoplasia mesenquimal maligna. O paciente foi submetido à ceratectomia seguida de flap de terceira pálpebra. Encaminhou-se o material excisado para análise histopatológica, e foi diagnosticado hemangiossarcoma. Após 15 dias, o flap de terceira pálpebra foi retirado, e, ao exame oftálmico, notou-se a recidiva da neoplasia, que recobria toda a córnea e parte da conjuntiva bulbar, procedendo-se à enucleação. O paciente foi submetido à ultrassonografia abdominal e à radiografia torácica sem nenhuma alteração evidente, o que caracterizou o caráter primário da afecção. Após dois anos do procedimento cirúrgico, o paciente encontra-se bem clinicamente, sem qualquer sinal de recidiva ou metástase. Apesar da exérese cirúrgica da neoplasia com margens limpas, em casos de hemangiossarcoma com comportamento agressivo, a enucleação deve ser considerada uma opção viável para um protocolo terapêutico de sucesso e melhor prognóstico do paciente.

  15. Clean elements in abelian rings

    Indian Academy of Sciences (India)

    equivalent to being clean for an abelian ring is 'topologically boolean'. In line with [1] we say that a ring R (not necessarily commutative) is right (resp. left) topologically boolean, or a right (resp. left) tb-ring for short, if for every pair of distinct maximal right (resp. left) ideals of R there is an idempotent in exactly one of them.

  16. The effects of chalazion excision on corneal surface aberrations. (United States)

    Park, Young Min; Lee, Jong Soo


    This study is the first to consider the effects of chalazion on corneal surface aberrations taking into account of corneal zones, and to establish the size standard for the excision of chalazion. Twenty three eyes from 23 patients with central upper eyelid chalazion larger than 3mm were recruited in this prospective study. The participants were classified into two groups, depending on size of the lesion: Group 1 with lesion size 3-5mm and Group 2 with lesion size >5mm Chalazion was excised by standard transconjunctival vertical incision. Corneal surface aberrations were measured using a Galilei™ analyzer and an auto-refractometer before and 2 months after the excision. Corneal astigmatism in all patients decreased significantly in both auto refractometer (P=0.012) and Galilei™ (P=0.020) measurements after chalazion excision. RMS of total HOAs decreased significantly in 6mm (P=0.043) and 3mm zone (P=0.051). The RMS of Zernike orders in the vertical and horizontal trefoil decreased significantly in 6mm (P=0.035) and 3mm (P=0.041) zone. Group 2 showed a significant decrease in corneal astigmatism in both auto refractometer (P=0.040) and Galilei™ (P=0.017) parameters after chalazion excision. Group 1 showed an insignificant decrease in corneal astigmatism. Unlike Group 1, the RMS of total HOAs and vertical and horizontal trefoil in 6mm zone decreased significantly in Group 2 (Pchalazion increases astigmatism and HOAs, especially at the peripheral cornea. Significantly induced astigmatism and HOAs are caused by chalazion >5mm in size. Thus, we recommend the surgical excision of chalazion >5mm in size to reduce corneal surface aberrations. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  17. Expansion and cryopreservation of porcine and human corneal endothelial cells. (United States)

    Marquez-Curtis, Leah A; McGann, Locksley E; Elliott, Janet A W


    Impairment of the corneal endothelium causes blindness that afflicts millions worldwide and constitutes the most often cited indication for corneal transplants. The scarcity of donor corneas has prompted the alternative use of tissue-engineered grafts which requires the ex vivo expansion and cryopreservation of corneal endothelial cells. The aims of this study are to culture and identify the conditions that will yield viable and functional corneal endothelial cells after cryopreservation. Previously, using human umbilical vein endothelial cells (HUVECs), we employed a systematic approach to optimize the post-thaw recovery of cells with high membrane integrity and functionality. Here, we investigated whether improved protocols for HUVECs translate to the cryopreservation of corneal endothelial cells, despite the differences in function and embryonic origin of these cell types. First, we isolated endothelial cells from pig corneas and then applied an interrupted slow cooling protocol in the presence of dimethyl sulfoxide (Me 2 SO), with or without hydroxyethyl starch (HES). Next, we isolated and expanded endothelial cells from human corneas and applied the best protocol verified using porcine cells. We found that slow cooling at 1 °C/min in the presence of 5% Me 2 SO and 6% HES, followed by rapid thawing after liquid nitrogen storage, yields membrane-intact cells that could form monolayers expressing the tight junction marker ZO-1 and cytoskeleton F-actin, and could form tubes in reconstituted basement membrane matrix. Thus, we show that a cryopreservation protocol optimized for HUVECs can be applied successfully to corneal endothelial cells, and this could provide a means to address the need for off-the-shelf cryopreserved cells for corneal tissue engineering and regenerative medicine. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Ring Confidential Transactions

    Directory of Open Access Journals (Sweden)

    Shen Noether


    Full Text Available This article introduces a method of hiding transaction amounts in the strongly decentralized anonymous cryptocurrency Monero. Similar to Bitcoin, Monero is a cryptocurrency which is distributed through a proof-of-work “mining” process having no central party or trusted setup. The original Monero protocol was based on CryptoNote, which uses ring signatures and one-time keys to hide the destination and origin of transactions. Recently the technique of using a commitment scheme to hide the amount of a transaction has been discussed and implemented by Bitcoin Core developer Gregory Maxwell. In this article, a new type of ring signature, A Multilayered Linkable Spontaneous Anonymous Group signature is described which allows one to include a Pedersen Commitment in a ring signature. This construction results in a digital currency with hidden amounts, origins and destinations of transactions with reasonable efficiency and verifiable, trustless coin generation. The author would like to note that early drafts of this were publicized in the Monero Community and on the #bitcoin-wizards IRC channel. Blockchain hashed drafts are available showing that this work was started in Summer 2015, and completed in early October 2015. An eprint is also available at

  19. Tono-Pen XL tonometry during application of a suction ring in rabbits

    Directory of Open Access Journals (Sweden)

    Kounis Georgios A


    Full Text Available Abstract Background The purpose of this study is to evaluate the use of Tono-Pen XL in measuring IOP during the application of a suction ring in rabbit eyes with manometrically controlled IOP. Methods Tono-Pen XL was calibrated against direct manometry in 10 rabbit eyes. A suction ring was then applied in 4 rabbit eyes and the IOP was determined manometrically during suction ring application at 350 mmHg vacuum pressure. Finally, in 6 catheterized rabbit eyes the IOP was measured with Tono-Pen XL during suction ring application at suction vacuum from 350 to 650 mmHg, while keeping actual IOP stable at 30 mmHg and 60 mmHg. Results Linear regression analysis revealed that the Tono-pen XL was reliable for IOPs between 10 and 70 mmHg (R2 = 0.9855. Direct manometry during suction ring application showed no statistically significant variation of Tono-Pen XL readings when the incanulation manometry intraocular pressure changed from 30 mmHg to 60 mmHg and no statistically significant correlation between suction vacuum and IOP measurements. Conclusion Tono-Pen XL measurements are unreliable during the application of a suction ring on living rabbit eyes even when the actual IOP is forced to be within the validated range of Tono-Pen XL measurements. This inaccuracy is probably related to altered corneal and scleral geometry and stress.

  20. Tono-Pen XL tonometry during application of a suction ring in rabbits. (United States)

    Charisis, Spyridon K; Ginis, Harilaos S; Kounis, Georgios A; Tsilimbaris, Miltiadis K


    The purpose of this study is to evaluate the use of Tono-Pen XL in measuring IOP during the application of a suction ring in rabbit eyes with manometrically controlled IOP. Tono-Pen XL was calibrated against direct manometry in 10 rabbit eyes. A suction ring was then applied in 4 rabbit eyes and the IOP was determined manometrically during suction ring application at 350 mmHg vacuum pressure. Finally, in 6 catheterized rabbit eyes the IOP was measured with Tono-Pen XL during suction ring application at suction vacuum from 350 to 650 mmHg, while keeping actual IOP stable at 30 mmHg and 60 mmHg. Linear regression analysis revealed that the Tono-pen XL was reliable for IOPs between 10 and 70 mmHg (R2 = 0.9855). Direct manometry during suction ring application showed no statistically significant variation of Tono-Pen XL readings when the incanulation manometry intraocular pressure changed from 30 mmHg to 60 mmHg and no statistically significant correlation between suction vacuum and IOP measurements. Tono-Pen XL measurements are unreliable during the application of a suction ring on living rabbit eyes even when the actual IOP is forced to be within the validated range of Tono-Pen XL measurements. This inaccuracy is probably related to altered corneal and scleral geometry and stress.

  1. Evaluation of the effects of resveratrol and bevacizumab on experimental corneal alkali burn. (United States)

    Doganay, Selim; Firat, Penpe Gul; Cankaya, Cem; Kirimlioglu, Hale


    To evaluate the effects of resveratrol and bevacizumab on experimental corneal neovascularization. A corneal alkali burn was performed in 62 eyes of 31 male white Vienna rabbits. Resveratrol (group 1), dimethyl sulfoxide (group 2), bevacizumab (group 3) and 0.9% NaCl (group 4) were administered to both eyes of the rabbits by subconjunctival injection for 7 days. Corneal photos were taken at 15 days after alkali injury. Inflammatory index scores and neovascularization areas were calculated. In bevacizumab group both inflammatory index scores and the calculation of the corneal neovascularization area was significantly less than the groups. The subconjunctival administration of bevacizumab inhibits corneal neovascularization effectively in the rabbit corneal alkali burn model. No effect of resveratrol to the corneal neovascularization on experimental model of the corneal alkali burn was seen at the doses of usage. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  2. Tectonic deep anterior lamellar keratoplasty in impending corneal perforation using cryopreserved cornea. (United States)

    Jang, Ji Hye; Chang, Sung Dong


    We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS® solution at -70℃ for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis. © 2011 The Korean Ophthalmological Society

  3. Corneal sensation after corneal refractive surgery with small incision lenticule extraction. (United States)

    Demirok, Ahmet; Ozgurhan, Engin Bilge; Agca, Alper; Kara, Necip; Bozkurt, Ercument; Cankaya, Kadir Ilker; Yilmaz, Omer Faruk


    To compare effects of small-incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (F-LASIK) on corneal sensation and dry eye parameters. In this prospective, randomized, contralateral-eye study, 28 patients with myopia or myopic astigmatism in both eyes were enrolled. One eye of each patient was treated by SMILE, and the fellow eye was treated by F-LASIK. Mean outcome measures Cochet-Bonnet esthesiometry, Schirmer test with anesthesia, tear breakup time, and tear film osmolarity were evaluated preoperatively as well as 1 week, 1 month, 3 months, and 6 months after surgery. Corneal sensation was reduced after both SMILE and F-LASIK surgeries 1 week, 1 month, and 3 months after surgery (p sensation was significantly lower after F-LASIK than after SMILE at postoperative 1 week, 1 month, and 3 months (p sensation 1 week, 1 month, and 3 months after surgery, they did not affect the dry eye parameters at any point.

  4. Transepithelial Riboflavin Absorption in an Ex Vivo Rabbit Corneal Model. (United States)

    Gore, Daniel M; O'Brart, David; French, Paul; Dunsby, Chris; Allan, Bruce D


    To measure depth-specific riboflavin concentrations in corneal stroma using two-photon fluorescence microscopy and compare commercially available transepithelial corneal collagen cross-linking (CXL) protocols. Transepithelial CXL riboflavin preparations--MedioCross TE, Ribocross TE, Paracel plus VibeX Xtra, and iontophoresis with Ricrolin+--were applied to the corneal surface of fresh postmortem rabbit eyes in accordance with manufacturers' recommendations for clinical use. Riboflavin 0.1% (VibeX Rapid) was applied after corneal epithelial debridement as a positive control. After riboflavin application, eyes were snap frozen in liquid nitrogen. Corneal cross sections 35-μm thick were cut on a cryostat, mounted on a slide, and imaged by two-photon fluorescence microscopy. Mean (SD) concentrations were calculated from five globes tested for each protocol. Peak riboflavin concentration of 0.09% (± 0.01) was observed within the most superficial stroma (stromal depth 0-10 μm) in positive controls (epithelium-off). At the same depth, peak stromal riboflavin concentrations for MedioCross TE, Ricrolin+, Paracel/Xtra, and Ribocross TE were 0.054% (± 0.01), 0.031% (0.003), 0.021% (± 0.001), and 0.015% (± 0.004), respectively. At a depth of 300 μm (within the demarcation zone commonly seen after corneal cross-linking), the stromal concentration in epithelium-off positive controls was 0.075% (± 0.006), while at the same depth MedioCross TE and Ricrolin+ achieved 0.018% (± 0.006) and 0.016% (0.002), respectively. None of the remaining transepithelial protocols achieved concentrations above 0.005% at this same 300-μm depth. Overall, MedioCross TE was the best-performing transepithelial formulation. Corneal epithelium is a significant barrier to riboflavin absorption into the stroma. Existing commercial transepithelial CXL protocols achieve relatively low riboflavin concentrations in the anterior corneal stroma when compared to gold standard epithelium-off absorption

  5. A new multiple noncontinuous puncture (pointage technique for corneal tattooing

    Directory of Open Access Journals (Sweden)

    Jin Hyoung Park


    Full Text Available AIM:To assess the safety and cosmetic efficacy of a new multiple noncontinuous transepithelial puncture technique for tattooing a decompensated cornea.METHODS:It was anon-comparative clinical case series study.The study examines 33 eyes in 33 patients with total corneal opacity due to corneal decompensation, which developed following intraocular surgery.Corneal tattooing was performed using the multiple noncontinuous transepithelial puncture technique (i.e. pointage. The safety of this new surgical strategy was assessed by occurrence of adverse events for the follow-up period. The cosmetic efficacy was determined by the patient’s cosmetic satisfaction and independent observer’s opinion about patient appearance.RESULTS:Seven women and 26 men were included in the study. The mean age was 46.4±17.5y (range:7-67. In total, 30 of 33 patients (91% reported cosmetic satisfaction within the follow-up period. Only 3 patients (9% required additional tattooing due to cosmetic unsatisfaction. Cosmetic outcomes were analyzed and classified as excellent or good in 13 (39% and 17 (52% patients, respectively. No serious adverse events developed, except delayed epithelial healing in 3 cases.CONCLUSION:The cosmetic outcomes of the multiple noncontinuous transepithelial puncture technique for corneal tattooing were good. The safety of this method is higher than conventional procedures. This new procedure also provides improved cost-effectiveness and safety over current corneal tattooing techniques.

  6. Temporary corneal stem cell dysfunction after radiation therapy

    International Nuclear Information System (INIS)

    Hiroshi, Fujishima; Kazuo, Tsubota


    Radiation therapy can cause corneal and conjuctival abnormalities that sometimes require surgical treatment. Corneal stem cell dysfunction is described, which recovered after the cessation of radiation. Methods - A 44-year-old man developed a corneal epithelial abnormality associated with conjuctival and corneal inflammation following radiation therapy for maxillary cancer. Examination of brush cytology samples showed goblet cells in the upper and lower parts of the cornea, which showed increased fluorescein permeability, and intraepithelial lymphocytes. Impression cytology showed goblet cells in the same part of the cornea. Specular microscopy revealed spindle type epithelial cells. Patient follow up included artificial tears and an antibiotic ophthalmic ointment. The corneal abnormalities resolved after 4 months with improved visual acuity without any surgical intervention, but the disappearance of the palisades of Vogt did not recover at 1 year after radiation. Radiation therapy in this patient caused temporary stem cell dysfunction which resulted in conjunctivalisation in a part of the cornea. Although limbal stem cell function did not fully recover, this rare case suggested that medical options should be considered before surgery. (Author)

  7. Chronic pesticide exposure and consequential keratectasia & corneal neovascularisation. (United States)

    Sanyal, Shalini; Law, Atrayo; Law, Sujata


    Ocular toxicity as a consequence of chronic pesticide exposure is one of the health hazards caused due to extended exposure to pesticides. The cornea, due to its position as the outer ocular layer and its role in protecting the internal layers of the eye; is gravely affected by this xenobiotic insult to the eye, leading to ocular irritation and damage to normal vision. The deleterious effects of chronic pesticide exposure on the various corneal layers and the ocular risks involved therein, were explored by mimicking the on-field scenario. Cytological, histological and flowcytometric parameters were taken into consideration to determine the enhanced risk of corneal neovascularisation and keratectasia, specifically, keratoconus. Chronic exposure to pesticides leads to heightened ocular morbidity wherein there were visible pathophysiological changes to the ocular surface. The cornea was found to be adversely affected with visible protuberance in a cone-like shape, characteristic of keratoconus in a majority of the experimental animals. Further analyses revealed a detrimental impact on all the corneal layers and an amplified expression of inflammation markers such as TNF-α, VCAM-1 and ICAM-1. Additionally, it was found that post pesticide exposure, the corneal surface developed hypoxia, leading to a significant increase of angiogenesis promoting factors and consequential neovascularisation. Apart from ocular toxicity, chronic exposure to pesticides significantly increases the risks of keratectasia and corneal neovascularisation; disorders which lead to diminished vision and if untreated, blindness. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Bioactive Antimicrobial Peptides as Therapeutics for Corneal Wounds and Infections. (United States)

    Griffith, Gina L; Kasus-Jacobi, Anne; Pereira, H Anne


    Significance: More than 2 million eye injuries and infections occur each year in the United States that leave civilians and military members with reduced or complete vision loss due to the lack of effective therapeutics. Severe ocular injuries and infections occur in varied settings including the home, workplace, and battlefields. In this review, we discuss the potential of developing antimicrobial peptides (AMPs) as therapeutics for the treatment of corneal wounds and infections for which the current treatment options are inadequate. Recent Advances: Standard-of-care employs the use of fluorescein dye for the diagnosis of ocular defects and is followed by the use of antibiotics and/or steroids to treat the infection and reduce inflammation. Recent advances for treating corneal wounds include the development of amniotic membrane therapies, wound chambers, and drug-loaded hydrogels. In this review, we will discuss an innovative approach using AMPs with the dual effect of promoting corneal wound healing and clearing infections. Critical Issues: An important aspect of treating ocular injuries is that treatments need to be effective and administered expeditiously. This is especially important for injuries that occur during combat and in individuals who demonstrate delayed wound healing. To overcome gaps in current treatment modalities, bioactive peptides based on naturally occurring cationic antimicrobial proteins are being investigated as new therapeutics. Future Directions: The development of new therapeutics that can treat ocular infections and promote corneal wound healing, including the healing of persistent corneal epithelial defects, would be of great clinical benefit.

  9. Determination of corneal elasticity coefficient using the ORA database. (United States)

    Avetisov, Sergei E; Novikov, Ivan A; Bubnova, Irina A; Antonov, Alexei A; Siplivyi, Vladimir I


    To propose a new approach for the study of corneal biomechanics using the Reichert Ocular Response Analyzer (ORA) database, which is based on changes in velocity retardation in the central cornea at the peak of flattening. The ORA applanation curve was analyzed using a mathematical technique, which allowed calculation of the elasticity coefficient (Ke), which is primarily characteristic of the elastic properties of the cornea. Elasticity coefficient values were obtained in patients with presumably different biomechanical properties of the cornea: "normal" cornea (71 eyes, normal group), keratoconus (34 eyes, keratoconus group), LASIK (36 eyes, LASIK group), and glaucoma with elevated and compensated intraocular pressure (lOP) (38 eyes, glaucoma group). The mean Ke value in the normal group was 11.05 +/- 1.6, and the corneal thickness correlation coefficient r2 was 0.48. In the keratoconus group, the mean Ke value was 4.91 +/- 1.87 and the corneal thickness correlation coefficient r2 was 0.47. In the LASIK group, Ke and r2 were 5.99 +/- 1.18 and 0.39, respectively. In the glaucoma group, the same eyes that experienced a two-fold reduction in lOP developed a statistically significant reduction in the Ke (1.06 times lower), whereas their corneal hysteresis value increased 1.25 times. The elasticity coefficient calculated using the ORA applanation curve can be used in the evaluation of corneal biomechanical properties.

  10. In vivo corneal neovascularization imaging by optical-resolution photoacoustic microscopy


    Liu, Wenzhong; Schultz, Kathryn M.; Zhang, Kevin; Sasman, Amy; Gao, Fengli; Kume, Tsutomu; Zhang, Hao F.


    Corneal neovascularization leads to blurred vision, thus in vivo visualization is essential for pathological studies in animal models. Photoacoustic (PA) imaging can delineate microvasculature and hemodynamics noninvasively, which is suitable for investigating corneal neovascularization. In this study, we demonstrate in vivo imaging of corneal neovascularization in the mouse eye by optical-resolution photoacoustic microscopy (OR-PAM), where corneal neovascularization is induced by deliberate ...

  11. Corneal endothelium of the Magellanic penguin (Spheniscus magellanicus) by scanning electron microscopy. (United States)

    Pigatto, João A T; Laus, José L; Santos, Jaime M; Cerva, Cristine; Cunha, Luciana S; Ruoppolo, Valéria; Barros, Paulo S M


    The corneal endothelium is essential for the maintenance of the corneal transparency. The aim of this study was to examine the morphology of the endothelial surface and perform morphometric analysis of the normal corneal endothelial cells of the Magellanic penguin (Spheniscus magellanicus) using scanning electron microscopy. The present work demonstrates that the corneal endothelium of the Magellanic penguin is similar to those described in other vertebrates.

  12. Effect of central corneal thickness and radius of the corneal curvature on intraocular pressure measured with the Tono-Pen and noncontact tonometer in healthy schoolchildren. (United States)

    Yildirim, Nilgun; Sahin, Afsun; Basmak, Hikmet; Bal, Cengiz


    To determine the effect of central corneal thickness and radius of the corneal curvature on intraocular pressure (IOP) measurements using the Tono-Pen and a noncontact tonometer in healthy Turkish schoolchildren. IOP was measured with the Tono-Pen and a noncontact tonometer in 602 eyes of 602 healthy schoolchildren with a mean age of 10.1 +/- 1.6 years. Central corneal thickness was measured using an ultrasonic pachymeter after all IOP determinations had been made. The effect of central corneal thickness, radius of the corneal curvature, and sex on measured IOP was explored by linear regression analysis. The mean central corneal thickness was found to be 564.92 +/- 32 microm. The mean IOP readings were 17.9 +/- 2 mm Hg using the Tono-Pen, and 16.7 +/- 2 mm Hg using a noncontact tonometer. The Tono-Pen measured IOP values slightly greater than the noncontact tonometer (P < .0001). A significant association between measured IOP and central corneal thickness was found with each device. The IOP increased 2.1 and 4.2 mm Hg with every 100-microm increase in central corneal thickness for the Tono-Pen and the noncontact tonometer, respectively. The dependence of IOP on central corneal thickness did not differ between boys and girls. There was a significant association between the Tono-Pen and noncontact tonometer differences and central corneal thickness; the noncontact tonometer tended to overestimate IOP in eyes with thicker corneas. The Tono-Pen readings appeared to be less affected by corneal thickness than those of the noncontact tonometer. The corneal radius of curvature had no significant effect on measured IOP with each device. Because the Tono-Pen was relatively easy to use and less affected by corneal thickness, it may be an alternative method for measuring IOP in children.

  13. Downregulation of PTEN at Corneal Wound Sites Accelerates Wound Healing through Increased Cell Migration


    Cao, Lin; Graue-Hernandez, Enrique O.; Tran, Vu; Reid, Brian; Pu, Jin; Mannis, Mark J.; Zhao, Min


    Wounding downregulates PTEN and activates the PI3 kinase/Akt pathway. Pharmacologic inhibition of PTEN stimulates the motility of corneal epithelial cells and corneal wound healing. These results imply that the inhibition of PTEN may be a plausible approach for corneal wounds.

  14. Discovery of Molecular Markers to Discriminate Corneal Endothelial Cells in the Human Body

    NARCIS (Netherlands)

    Yoshihara, Masahito; Ohmiya, Hiroko; Hara, Susumu; Kawasaki, Satoshi; Hayashizaki, Yoshihide; Itoh, Masayoshi; Kawaji, Hideya; Tsujikawa, Motokazu; Nishida, Kohji; Forrest, Alistair R. R.; Rehli, Michael; Baillie, J. Kenneth; de Hoon, Michiel J. L.; Haberle, Vanja; Lassmann, Timo; Kulakovskiy, Ivan V.; Lizio, Marina; Andersson, Robin; Mungall, Christopher J.; Meehan, Terrence F.; Schmeier, Sebastian; Bertin, Nicolas; Jørgensen, Mette; Dimont, Emmanuel; Arner, Erik; Schmidl, Christian; Schaefer, Ulf; Medvedeva, Yulia A.; Plessy, Charles; Vitezic, Morana; Severin, Jessica; Semple, Colin A.; Ishizu, Yuri; Francescatto, Margherita; Alam, Intikhab; Albanese, Davide; Altschuler, Gabriel M.; Archer, John A. C.; Arner, Peter; Babina, Magda; Baker, Sarah; Balwierz, Piotr J.; Beckhouse, Anthony G.; Pradhan-Bhatt, Swati; Blake, Judith A.; Blumenthal, Antje; Bodega, Beatrice; Bonetti, Alessandro; Briggs, James; Brombacher, Frank; Burroughs, A. Maxwell; Califano, Andrea; Cannistraci, Carlo V.; Carbajo, Daniel; Chen, Yun; Chierici, Marco; Ciani, Yari; Clevers, Hans C.; Dalla, Emiliano; Davis, Carrie A.; Detmar, Michael; Diehl, Alexander D.; Dohi, Taeko; Drabløs, Finn; Edge, Albert S. B.; Edinger, Matthias; Ekwall, Karl; Endoh, Mitsuhiro; Enomoto, Hideki; Fagiolini, Michela; Fairbairn, Lynsey; Fang, Hai; Farach-Carson, Mary C.; Faulkner, Geoffrey J.; Favorov, Alexander V.; Fisher, Malcolm E.; Frith, Martin C.; Fujita, Rie; Fukuda, Shiro; Furlanello, Cesare; Furuno, Masaaki; Furusawa, Jun-ichi; Geijtenbeek, Teunis B.; Gibson, Andrew; Gingeras, Thomas; Goldowitz, Daniel; Gough, Julian; Guhl, Sven; Guler, Reto; Gustincich, Stefano; Ha, Thomas J.; Hamaguchi, Masahide; Hara, Mitsuko; Harbers, Matthias; Harshbarger, Jayson; Hasegawa, Akira; Hasegawa, Yuki; Hashimoto, Takehiro; Herlyn, Meenhard; Hitchens, Kelly J.; Ho Sui, Shannan J.; Hofmann, Oliver M.; Hoof, Ilka; Hori, Fumi; Huminiecki, Lukasz; Iida, Kei; Ikawa, Tomokatsu; Jankovic, Boris R.; Jia, Hui; Joshi, Anagha; Jurman, Giuseppe; Kaczkowski, Bogumil; Kai, Chieko; Kaida, Kaoru; Kaiho, Ai; Kajiyama, Kazuhiro; Kanamori-Katayama, Mutsumi; Kasianov, Artem S.; Kasukawa, Takeya; Katayama, Shintaro; Kato, Sachi; Kawaguchi, Shuji; Kawamoto, Hiroshi; Kawamura, Yuki I.; Kawashima, Tsugumi; Kempfle, Judith S.; Kenna, Tony J.; Kere, Juha; Khachigian, Levon M.; Kitamura, Toshio; Klinken, S. Peter; Knox, Alan J.; Kojima, Miki; Kojima, Soichi; Kondo, Naoto; Koseki, Haruhiko; Koyasu, Shigeo; Krampitz, Sarah; Kubosaki, Atsutaka; Kwon, Andrew T.; Laros, Jeroen F. J.; Lee, Weonju; Lennartsson, Andreas; Li, Kang; Lilje, Berit; Lipovich, Leonard; Mackay-sim, Alan; Manabe, Ri-ichiroh; Mar, Jessica C.; Marchand, Benoit; Mathelier, Anthony; Mejhert, Niklas; Meynert, Alison; Mizuno, Yosuke; Morais, David A. de Lima; Morikawa, Hiromasa; Morimoto, Mitsuru; Moro, Kazuyo; Motakis, Efthymios; Motohashi, Hozumi; Mummery, Christine L.; Murata, Mitsuyoshi; Nagao-Sato, Sayaka; Nakachi, Yutaka; Nakahara, Fumio; Nakamura, Toshiyuki; Nakamura, Yukio; Nakazato, Kenichi; van Nimwegen, Erik; Ninomiya, Noriko; Nishiyori, Hiromi; Noma, Shohei; Nozaki, Tadasuke; Ogishima, Soichi; Ohkura, Naganari; Ohno, Hiroshi; Ohshima, Mitsuhiro; Okada-Hatakeyama, Mariko; Okazaki, Yasushi; Orlando, Valerio; Ovchinnikov, Dmitry A.; Pain, Arnab; Passier, Robert; Patrikakis, Margaret; Persson, Helena; Piazza, Silvano; Prendergast, James G. D.; Rackham, Owen J. L.; Ramilowski, Jordan A.; Rashid, Mamoon; Ravasi, Timothy; Rizzu, Patrizia; Roncador, Marco; Roy, Sugata; Rye, Morten B.; Saijyo, Eri; Sajantila, Antti; Saka, Akiko; Sakaguchi, Shimon; Sakai, Mizuho; Sato, Hiroki; Satoh, Hironori; Savvi, Suzana; Saxena, Alka; Schneider, Claudio; Schultes, Erik A.; Schulze-Tanzil, Gundula G.; Schwegmann, Anita; Sengstag, Thierry; Sheng, Guojun; Shimoji, Hisashi; Shimoni, Yishai; Shin, Jay W.; Simon, Christophe; Sugiyama, Daisuke; Sugiyama, Takaaki; Suzuki, Masanori; Swoboda, Rolf K.; 't Hoen, Peter A. C.; Tagami, Michihira; Takahashi, Naoko; Takai, Jun; Tanaka, Hiroshi; Tatsukawa, Hideki; Tatum, Zuotian; Thompson, Mark; Toyoda, Hiroo; Toyoda, Tetsuro; Valen, Eivind; van de Wetering, Marc; van den Berg, Linda M.; Verardo, Roberto; Vijayan, Dipti; Vorontsov, Ilya E.; Wasserman, Wyeth W.; Watanabe, Shoko; Wells, Christine A.; Winteringham, Louise N.; Wolvetang, Ernst; Wood, Emily J.; Yamaguchi, Yoko; Yamamoto, Masayuki; Yoneda, Misako; Yonekura, Yohei; Yoshida, Shigehiro; Zabierowski, Suzan E.; Zhang, Peter G.; Zhao, Xiaobei; Zucchelli, Silvia; Summers, Kim M.; Suzuki, Harukazu; Daub, Carsten O.; Kawai, Jun; Heutink, Peter; Hide, Winston; Freeman, Tom C.; Lenhard, Boris; Bajic, Vladimir B.; Taylor, Martin S.; Makeev, Vsevolod J.; Sandelin, Albin; Hume, David A.; Carninci, Piero


    The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs) on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant

  15. Corneal donations in South Africa: A 15-year review | York | South ...

    African Journals Online (AJOL)

    Background. Corneal pathology is one of the leading causes of preventable blindness in South Africa (SA). A corneal transplant can restore or significantly improve vision in most cases. However, in SA there is a gross shortage of corneal tissue available to ophthalmologists. Little has been published describing the ...

  16. Síndrome erosivo corneal recurrente enmascarado como queratitis epitelial herpética

    Directory of Open Access Journals (Sweden)

    Manuel A. de Alba-Castilla


    Conclusiones: Los rasgos distintivos del SECR son: inicio abrupto por la noche o madrugada al despertar, antecedente de trauma corneal o distrofia corneal anterior y ausencia de leucomas corneales. La semejanza sintomatológica y el desconocimiento del SECR incrementan la posibilidad de confundir el diagnóstico.

  17. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers


    Zhang, Ting; Wang, Yuexin; Jia, Yanni; Liu, Dongle; Li, Suxia; Shi, Weiyun; Gao, Hua


    Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded...

  18. SOR-ring failure

    International Nuclear Information System (INIS)

    Kitamura, Hideo


    It was in the autumn of 1976 that the SOR-ring (synchrotron radiation storage ring) has commenced the regular operation. Since then, the period when the operation was interrupted due to the failures of SOR-ring itself is in total about 8 weeks. Failures and accidents have occurred most in the vacuum system. Those failure experiences are described on the vacuum, electromagnet, radio-frequency acceleration and beam transport systems with their interrupted periods. The eleven failures in the vacuum system have been reported, such as bellows breakage in a heating-evacuating period, leakage from the bellows of straight-through valves (made in U.S.A. and Japan), and leakage from the joint flange of the vacuum system. The longest interruption was 5 weeks due to the failure of a domestically manufactured straight-through valve. The failures of the electromagnet system involve the breakage in a cooling water system, short circuit of a winding in the Q magnet power transformer, blow of a fuse protecting the deflection magnet power source by the current less than the rating, and others. The failures of the RF acceleration system include the breakage of an output electronic tube the breakage of a cavity ceramic, RF voltage fluctuation due to the contact deterioration at a cavity electrode, and the failure of grid bias power source. It is necessary to select the highly reliable components for the vacuum system because the vacuum system failures require longer time for recovery, and very likely to induce secondary and tertiary failures. (Wakatsuki, Y.)

  19. Generation of Femtosecond Laser-Cut Decellularized Corneal Lenticule Using Hypotonic Trypsin-EDTA Solution for Corneal Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Man-Il Huh


    Full Text Available Purpose. To establish an optimized and standardized protocol for the development of optimal scaffold for bioengineering corneal substitutes, we used femtosecond laser to process human corneal tissue into stromal lenticules and studied to find the most efficient decellularization method among various reagents with different tonicities. Methods. The decellularization efficacy of several agents (0.1%, 0.25%, and 0.5% of Triton X-100, SDS, and trypsin-EDTA (TE, resp. with different tonicities was evaluated. Of all protocols, the decellularization methods, which efficiently removed nuclear materials examined as detected by immunofluorescent staining, were quantitatively tested for sample DNA and glycosaminoglycan (GAG contents, recellularization efficacy, and biocompatibilities. Results. 0.5% SDS in hypertonic and isotonic buffer, 0.25% TE in hypotonic buffer, and 0.5% TE in all tonicities completely decellularized the corneal lenticules. Of the protocols, decellularization with hypotonic 0.25 and 0.5% TE showed the lowest DNA contents, while the GAG content was the highest. Furthermore, the recellularization efficacy of the hypotonic TE method was better than that of the SDS-based method. Hypotonic TE-treated decellularized corneal lenticules (DCLs were sufficiently transparent and biocompatible. Conclusion. We generated an ideal protocol for DCLs using a novel method. Furthermore, it is possible to create a scaffold using a bioengineered corneal substitute.

  20. Corneal Biomechanical Properties after FS-LASIK with Residual Bed Thickness Less Than 50% of the Original Corneal Thickness

    Directory of Open Access Journals (Sweden)

    Haixia Zhang


    Full Text Available Background. The changes in corneal biomechanical properties after LASIK remain an unknown but important topic for surgical design and prognostic evaluation. This study aims to observe the postoperative corneal biomechanical properties one month after LASIK with amount of corneal cutting (ACC greater than 50% of the central corneal thickness (CCT. Methods. FS-LASIK was performed in 10 left rabbit eyes with ACC being 60% (L60 and 65% (L65 of the CCT, while the right eyes (R were the control. After 4 weeks, rabbits were executed and corneal strip samples were prepared for uniaxial tensile tests. Results. At the same strain, the stresses of L65 and L60 were larger than those of R. The elastic moduli of L60 and L65 were larger than those of R when the stress was 0.02 MPa, while they began to be less than those of R when stress exceeds the low-stress region. After 10 s relaxation, the stress of specimens L65, L60, and R increased in turn. Conclusion. The elastic moduli of the cornea after FS-LASIK with ACC greater than 50% of the CCT do not become less under normal rabbit IOP. The limit stress grows with the rise of ACC when relaxation becomes stable.

  1. Measurement of Angle Kappa Using Ultrasound Biomicroscopy and Corneal Topography. (United States)

    Yeo, Joon Hyung; Moon, Nam Ju; Lee, Jeong Kyu


    To introduce a new convenient and accurate method to measure the angle kappa using ultrasound biomicroscopy (UBM) and corneal topography. Data from 42 eyes (13 males and 29 females) were analyzed in this study. The angle kappa was measured using Orbscan II and calculated with UBM and corneal topography. The angle kappa of the dominant eye was compared with measurements by Orbscan II. The mean patient age was 36.4 ± 13.8 years. The average angle kappa measured by Orbscan II was 3.98° ± 1.12°, while the average angle kappa calculated with UBM and corneal topography was 3.19° ± 1.15°. The difference in angle kappa measured by the two methods was statistically significant (p topography to calculate the angle kappa. This method is convenient to use and allows for measurement of the angle kappa without an expensive device. © 2017 The Korean Ophthalmological Society

  2. Tectonic corneal graft for conjunctival rhinosporidiosis with scleral melt

    Directory of Open Access Journals (Sweden)

    Pushpa Jacob


    Full Text Available A 16 year old girl presented with irritation and watering of the right eye for 3 months. On examination, the superior perilimbal sclera was ectatic with incarcerated uveal tissue covered by conjunctiva. The conjunctiva showed discreet, yellow white mucoid spots. Excision biopsy of the conjunctiva showed subepithelial spherules of sporangia containing numerous endospores, suggestive of rhinosporidiosis. Diathermy was applied to flatten the staphyloma. The ectatic area was covered with a corneal patch graft. The patient was started on prednisolone acetate eye drops and oral dapsone for 6 months. Corneal graft was well incorporated and conjunctivalized by 3 months. Since the graft was not seen within the palpebral aperture, there was good cosmetic result. The corneal graft had the added advantage of transparency which allowed visualization of the underlying tissue to diagnose early recurrence. There was no recurrence at 6 months.

  3. Photo-activated riboflavin therapy of refractory corneal ulcers. (United States)

    Panda, Anita; Krishna, Sasikala N; Kumar, Sandeep


    To evaluate the therapeutic effect of photo-activated riboflavin (PAR) for treating refractory corneal ulcers. Seven eyes with infectious keratitis, presented with a gradually deteriorating, vision-threatening, corneal ulcer, despite intense antimicrobial therapy, were treated with PAR. The surgical procedure was deepithelialization of the affected corneas followed by UV-A riboflavin (B2) cross-linking. Local antimicrobial therapy was continued after the procedure. In all cases, the progression of corneal melting was halted after PAR treatment. Emergency keratoplasty was not necessary in any of the 7 eyes presented. More importantly, all the ulcers were healed without significant vascularization. PAR is a promising option for treating patients with therapy-refractory infectious keratitis to avoid emergency keratoplasty and should be considered as a potential adjuvant therapeutic tool in such eyes.

  4. Corneal wound healing is compromised by immunoproteasome deficiency.

    Directory of Open Access Journals (Sweden)

    Deborah A Ferrington

    Full Text Available Recent studies have revealed roles for immunoproteasome in regulating cell processes essential for maintaining homeostasis and in responding to stress and injury. The current study investigates how the absence of immunoproteasome affects the corneal epithelium under normal and stressed conditions by comparing corneas from wildtype (WT mice and those deficient in two immunoproteasome catalytic subunits (lmp7(-/-/mecl-1(-/-, L7M1. Immunoproteasome expression was confirmed in WT epithelial cells and in cells of the immune system that were present in the cornea. More apoptotic cells were found in both corneal explant cultures and uninjured corneas of L7M1 compared to WT mice. Following mechanical debridement, L7M1 corneas displayed delayed wound healing, including delayed re-epithelialization and re-establishment of the epithelial barrier, as well as altered inflammatory cytokine production compared to WT mice. These results suggest that immunoproteasome plays an important role in corneal homeostasis and wound healing.

  5. Femtoslicing in Storage Rings

    CERN Document Server

    Khan, Shaukat


    The generation of ultrashort synchrotron radiation pulses by laser-induced energy modulation of electrons and their subsequent transverse displacement, now dubbed "femtoslicing," was demonstrated at the Advanced Light Source in Berkeley. More recently, a femtoslicing user facility was commissioned at the BESSY storage ring in Berlin, and another project is in progress at the Swiss Light Source. The paper reviews the principle of femtoslicing, its merits and shortcomings, as well as the variations of its technical implementation. Various diagnostics techniques to detect successful laser-electron interaction are discussed and experimental results are presented.

  6. Proton storage rings

    International Nuclear Information System (INIS)

    Rau, R.R.


    A discussion is given of proton storage ring beam dynamic characteristics. Topics considered include: (1) beam energy; (2) beam luminosity; (3) limits on beam current; (4) beam site; (5) crossing angle; (6) beam--beam interaction; (7) longitudinal instability; (8) effects of scattering processes; (9) beam production; and (10) high magnetic fields. Much of the discussion is related to the design parameters of ISABELLE, a 400 x 400 GeV proton---proton intersecting storage accelerator to be built at Brookhaven National Laboratory

  7. Fusion Rings for Quantum Groups

    DEFF Research Database (Denmark)

    Andersen, Henning Haahr; Stroppel, Catharina


    We study the fusion rings of tilting modules for a quantum group at a root of unity modulo the tensor ideal of negligible tilting modules. We identify them in type A with the combinatorial rings from Korff, C., Stroppel, C.: The sl(ˆn)k-WZNW fusion ring: a combinato-rial construction and a realis......We study the fusion rings of tilting modules for a quantum group at a root of unity modulo the tensor ideal of negligible tilting modules. We identify them in type A with the combinatorial rings from Korff, C., Stroppel, C.: The sl(ˆn)k-WZNW fusion ring: a combinato-rial construction...... and a realisation as quotient of quantum cohomology. Adv. Math. 225(1), 200–268, (2010) and give a similar description of the sp2n-fusion ring in terms of non-commutative symmetric functions. Moreover we give a presentation of all fusion rings in classical types as quotients of polynomial rings. Finally we also...... compute the fusion rings for type G2....

  8. Viscosity of ring polymer melts

    KAUST Repository

    Pasquino, Rossana


    We have measured the linear rheology of critically purified ring polyisoprenes, polystyrenes, and polyethyleneoxides of different molar masses. The ratio of the zero-shear viscosities of linear polymer melts η0,linear to their ring counterparts η0,ring at isofrictional conditions is discussed as a function of the number of entanglements Z. In the unentangled regime η0,linear/η 0,ring is virtually constant, consistent with the earlier data, atomistic simulations, and the theoretical expectation η0,linear/ η0,ring = 2. In the entanglement regime, the Z-dependence of ring viscosity is much weaker than that of linear polymers, in qualitative agreement with predictions from scaling theory and simulations. The power-law extracted from the available experimental data in the rather limited range 1 < Z < 20, η0,linear/η0,ring ∼ Z 1.2±0.3, is weaker than the scaling prediction (η0,linear/η0,ring ∼ Z 1.6±0.3) and the simulations (η0,linear/ η0,ring ∼ Z2.0±0.3). Nevertheless, the present collection of state-of-the-art experimental data unambiguously demonstrates that rings exhibit a universal trend clearly departing from that of their linear counterparts, and hence it represents a major step toward resolving a 30-year-old problem. © 2013 American Chemical Society.

  9. Saturn ring temperature variations with approaching ring equinox (United States)

    Spilker, L.; Leyrat, C.; Flandes, A.; Altobelli, N.; Pilorz, S.; Ferrari, C.; Edgington, S.


    Cassini's Composite Infrared Spectrometer (CIRS) has acquired a wide-ranging set of thermal measurements of Saturn's main rings (A, B, C and Cassini Division) at solar elevations ranging from less than one degree to 24 degrees. At Saturn equinox in August the solar elevation angle will reach zero as the sun traverses from the south to north side of the rings. For the data acquired to date, temperatures were retrieved for the lit and unlit rings over a variety of ring geometries that include solar elevation, as well as spacecraft elevation, phase angle and local hour angle. To first order, the largest temperature changes on the lit face of the rings are driven by variations in phase angle while differences in temperature with changing spacecraft elevation and local time are a secondary effect. Decreasing ring temperature with decreasing solar elevation are observed for both the lit and unlit faces of the rings after phase angle and local time effects are taken into account. As the solar elevation continues to decrease, the ring temperatures are decreasing in a non-linear fashion. The difference in temperature between the lit and unlit sides of the rings is decreasing also with decreasing solar elevation. Using ring thermal models developed by Leyrat we extrapolate to the expected minimum ring temperatures at equinox for our planned CIRS ring observations. This research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under contract with NASA and at CEA Saclay supported by the "Programme National de Planetologie". Copyright 2009 California Institute of Technology. Government sponsorship acknowledged.

  10. Traumatic Wound Dehiscence following Corneal Transplantation

    Directory of Open Access Journals (Sweden)

    Mohammad-Reza Jafarinasab


    Full Text Available Purpose: To investigate the incidence, mechanisms, characteristics, and visual outcomes of traumatic wound dehiscence following keratoplasty. Methods: Medical records of 32 consecutive patients with traumatic globe rupture following keratoplasty who had been treated at our center from 2001 to 2009 were retrospectively reviewed. Results: The study population consisted of 32 eyes of 32 patients including 25 men and 7 women with history of corneal transplantation who had sustained eye trauma leading to globe rupture. Mean patient age was 38.1 (range, 8 to 87 years and median interval between keratoplasty and the traumatic event was 9 months (range, 30 days to 20 years. Associated anterior segment findings included iris prolapse in 71.9%, lens extrusion in 34.4%, and hyphema in 40.6% of eyes. Posterior segment complications included vitreous prolapse (56%, vitreous hemorrhage (28% and retinal detachment (18%. Eyes which had undergone deep anterior lamellar keratoplasty (DALK; 5 cases, 15.6% tended to have less severe presentation and better final visual acuity. There was no correlation between the time interval from keratoplasty to the traumatic event, and final visual outcomes. Conclusion: The host-graft interface demonstrates decreased stability long after surgery and the visual prognosis of traumatic wound dehiscence is poor in many cases. An intact Descemet′s membrane in DALK may mitigate the severity of ocular injuries, but even in these cases, the visual outcome of globe rupture is not good and prevention of ocular trauma should be emphasized to all patients undergoing any kind of keratoplasty.

  11. The theory and art of corneal cross-linking

    Directory of Open Access Journals (Sweden)

    Rebecca McQuaid


    Full Text Available Before the discovery of corneal cross-linking (CXL, patients with keratoconus would have had to undergo corneal transplantation, or wear rigid gas permeable lenses (RGPs that would temporarily flatten the cone, thereby improving the vision. The RGP contact lens (CL would not however alter the corneal stability and if the keratoconus was progressive, the continued steepening of the cone would occur under the RGP CL. To date, the Siena Eye has been the largest study to investigate long term effects of standard CXL. Three hundred and sixty-three eyes were treated and monitored over 4 years, producing reliable long-term results proving long-term stability of the cornea by halting the progression of keratoconus, and proving the safety of the procedure. Traditionally, CXL requires epithelial removal prior to corneal soakage of a dextran-based 0.1% riboflavin solution, followed by exposure of ultraviolet-A (UV-A light for 30 min with an intensity of 3 mW/cm2. A series of in vitro investigations on human and porcine corneas examined the best treatment parameters for standard CXL, such as riboflavin concentration, intensity, wavelength of UV-A light, and duration of treatment. Photochemically, CXL is achieved by the generation of chemical bonds within the corneal stroma through localized photopolymerization, strengthening the cornea whilst minimizing exposure to the surrounding structures of the eye. In vitro studies have shown that CXL has an effect on the biomechanical properties of the cornea, with an increased corneal rigidity of approximately 70%. This is a result of the creation of new chemical bonds within the stroma.

  12. Corneal complications and visual impairment in vernal keratoconjunctivitis patients

    International Nuclear Information System (INIS)

    Arif, A.S.; Aaqil, B.; Siddiqui, A.; Nazneen, Z.; Farooq, U.


    Vernal kerato-conjunctivitis (VKC) is an infrequent but serious form of allergic conjunctivitis common in warm and humid areas where air is rich in allergens. It affects both eyes asymmetrically. Although VKC is a self-limiting disease but visions affecting corneal complications influence the quality of life in school children. The aim of this study was to list the corneal complications due to this condition and to find out the extent of visual impairment among VKC patients. Methods: This cross-sectional study was conducted in the department of Ophthalmology, Benazir Bhutto Shaheed Hospital on 290 eyes of diagnosed cases of VKC. The diagnosis of VKC was made on the basis of history and examination. Visual acuity was recorded using Snellen's notation and visual impairment was classified according to World Health Organization classification for visual disabilities. Results: The mean age of presentation was 10.83+-6.13 years. There were 207 (71.4%) males and 83 (28.6%) females. Corneal scarring was observed in 59 (20.3%) eyes. Keratoconus was found to be in 17 (5.9%) eyes. Shield ulcer was detected in 09 (3.1%) eyes while 07 (2.4%) eyes had corneal neovascularization. Majority of the patients with visual loss had corneal scarring and the complication that led to severe visual loss in most of the eyes was Keratoconus. Conclusion: Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment. (author)

  13. Community practice patterns for bacterial corneal ulcer evaluation and treatment. (United States)

    Park, Jennifer; Lee, Kim M; Zhou, Helen; Rabin, Moriah; Jwo, Kevin; Burton, William B; Gritz, David C


    To examine current practice patterns in the management of bacterial keratitis among U.S. ophthalmologists and differences in the management and opinions between cornea specialists and non-cornea specialists. A questionnaire was distributed to randomly selected ophthalmologists in July 2011 using an online survey system. It inquired about the number of patients with corneal ulcers seen monthly, frequency of Gram staining and culturing corneal ulcers, maintenance of diagnostic supplies, opinions on when culturing is necessary for corneal ulcers, treatment preferences for different severities of bacterial corneal ulcers, and opinions regarding relative efficacy of fourth-generation fluoroquinolones and fortified broad-spectrum antibiotics. One thousand seven hundred one surveys were distributed, and 486 (28.6%) surveys were returned. A minority of corneal ulcers was Gram stained (23.7%±34.1%, mean±SD) or cultured (35.1%±38.0%), but cornea specialists were more likely to perform both. The most popular antibiotic for the treatment of less severe ulcers was moxifloxacin (55.4%), and the most popular treatment of more severe ulcers was fortified broad-spectrum antibiotics (62.7%). Cornea specialists were significantly more likely than non-cornea specialists to prescribe fortified antibiotics for more severe corneal ulcers (78.1% vs. 53.7%, Pcorneal ulcers (79.6% of cornea specialists vs. 60.9% of non-cornea specialists, P<0.001). Cornea specialists and non-cornea specialists manage bacterial keratitis differently, with cornea specialists more likely to perform diagnostic testing and prescribe fortified broad-spectrum antibiotics for severe bacterial keratitis. Additional prospective studies demonstrating visual outcomes after differential treatment of bacterial keratitis are needed.


    Directory of Open Access Journals (Sweden)

    E. A. Kasparova


    Full Text Available Aim. To improve the treatment of early infectious corneal ulcers by combining microdiathermocoagulation (MDC, external autocytokinotherapy, and antiviral and/or antibacterial therapy. patients and methods. The study enrolled 2 groups of outpatients (a total of 112 patients, 112 eyes who either showed no improvement or deteriorated under 7-day to 1.5-month therapeutic treatment. Group I included 70 patients (70 eyes with superficial corneal ulcers due to herpes virus infection under antiviral therapy (instillations and periocular injections of Poludan (PolyA:PoliU as well as Zovirax 3% ophthalmic ointment, group II — 42 patients (42 eyes with early-stage purulent corneal ulcers under instillations of modern antibiotics (current-generation fluoroquinolones. results and discussion. The combination of MDC and external autocytokinotherapy is the most effective treatment for torpid herpetic ulcerative keratitis that allows a reliable reduction in the recovery period: from 24.1±2.2 days (therapeutic treatment only down to 9.2±1.3 days (both methods plus antiviral therapy. Moreover, MDC is the treatment of choice in outpatients with purulent corneal ulcer in its early stage. The healing period in this case can be also reliably reduced (р<0.05 from 18.6±1.9 days (MDC plus antibacterial therapy. Hence, MDC is a highly effective urgent method of treatment available to ambulatory care patients with herpetic keratitis and early-stage purulent corneal ulcers. External autocytokinotherapy shows a pronounced anti-inflammatory and regenerative effect. When applied together, MDC and external autocytokinotherapy act synergistically and provide twice as short treatment periods. MDC as well as its combination with external autocytokinotherapy, if started early, allow to avoid keratoplasty in most patients with herpetic keratitis and early-stage purulent corneal ulcers.

  15. Karyotype changes in cultured human corneal endothelial cells


    Miyai, Takashi; Maruyama, Yoko; Osakabe, Yasuhiro; Nejima, Ryohei; Miyata, Kazunori; Amano, Shiro


    Purpose To examine karyotype changes in cultured human corneal endothelial cells (HCECs). Methods HCECs with Descemet’s membrane were removed from 20 donors of various ages (range, 2–77 years; average, 43.7±26.4 years) and cultured on dishes coated with extracellular matrix produced by bovine corneal endothelial cells (BCECs). Karyotype changes were examined by G-band karyotyping of HCECs at the third passage from 12 donors and the fifth passage from 16 donors. The number of chromosomes was a...

  16. Ring Image Analyzer (United States)

    Strekalov, Dmitry V.


    Ring Image Analyzer software analyzes images to recognize elliptical patterns. It determines the ellipse parameters (axes ratio, centroid coordinate, tilt angle). The program attempts to recognize elliptical fringes (e.g., Newton Rings) on a photograph and determine their centroid position, the short-to-long-axis ratio, and the angle of rotation of the long axis relative to the horizontal direction on the photograph. These capabilities are important in interferometric imaging and control of surfaces. In particular, this program has been developed and applied for determining the rim shape of precision-machined optical whispering gallery mode resonators. The program relies on a unique image recognition algorithm aimed at recognizing elliptical shapes, but can be easily adapted to other geometric shapes. It is robust against non-elliptical details of the image and against noise. Interferometric analysis of precision-machined surfaces remains an important technological instrument in hardware development and quality analysis. This software automates and increases the accuracy of this technique. The software has been developed for the needs of an R&TD-funded project and has become an important asset for the future research proposal to NASA as well as other agencies.

  17. Flexible ring seal

    International Nuclear Information System (INIS)

    Abbes, Claude; Gournier, Andre; Rouaud, Christian; Villepoix, Raymond de.


    The invention concerns a flexible metal ring seal, able to ensure a perfect seal between two bearings due to the crushing and elastic deformation properties akin to similar properties in elastomers. Various designs of seal of this kind are already known, particularly a seal made of a core formed by a helical wire spring with close-wound turns and with high axial compression ratio, closed on itself and having the shape of an annulus. This wire ring is surrounded by at least one envelope having at rest the shape of a toroidal surface of which the generating circle does not close on itself. In a particular design mode, the seal in question can include, around the internal spring, two envelopes of which one in contact with the spring is composed of a low ductility elastic metal, such as mild steel or stainless steel and the other is, on the contrary, made of a malleable metal, such as copper or nickel. The first envelope evenly distributes the partial crushing of the spring, when the seal is tightened, on the second envelope which closely fits the two surfaces between which the seal operates. The stress-crushing curve characteristic of the seal comprises two separate parts, the first with a relatively sharp slope corresponds to the start of the seal compression phase, enabling at least some of these curves to reach the requisite seal threshold very quickly, then, beyond this, a second part, practically flat, where the stress is appreciably constant for a wide operating bracket [fr

  18. NRL ion ring program

    International Nuclear Information System (INIS)

    Kapetanakos, C.A.; Golden, J.; Drobot, A.; Mahaffey, R.A.; Marsh, S.J.; Pasour, J.A.


    An experiment is under way to form a storng proton ring using the 200 ka, 1.2 MeV, 50 nsec hollow proton beam recently generated at NRL. The 5 m long magnetic field configuration consists of a magnetic cusp, a compressing magnetic field, a gate field and a magnetic mirror. The midplane value of the magnetic mirror is such that the major radius of the ring will be about 10 cm. The degree of field reversal that will be achieved with 5 x 10 16 protons per pulse from the existing beam depends upon the field reversal is possible with the 600 kA proton beam that would be generated from the low inductance coaxial triode coupled to the upgraded Gamble II generator. The propagation and trapping of an intense proton beam in the experimental magnetic field configuration is investigated numerically. The results show that the self magnetic has a very pronounced effect on the dynamics of the gyrating protons

  19. On thickness of Saturn rings

    International Nuclear Information System (INIS)

    Brahic, Andre; Laques, Pierre; Lecacheux, Jean; Servan, Bernard; Despiau, Raymond; Michet, Daniel; Renard, Leopold


    Electronographic plates of Saturn were taken during the transit of the Earth through the ring plane. Observing conditions were more favorable than those prevailing in 1966. Thanks to the quality of the detectors and the telescopes, it has been possible to make a more precise photometric determination of the brightness of the ring seen edge on and to measure the brightness variation with respect to the distance to the center of the planet. Extrapolating to the case where the elevation of the Earth above the ring plane is strictly zero, we deduce an apparent photometric ring thickness equal to 1.5+-0.3 km. For an homogeneous layer of small particles colliding inelastically, theory predicts a thickness of the order of a few particles radii, i.e. a few tens of meters. The observed brightness could be explained by the E ring, the brightness of large chunks, condensations and warping of the ring [fr

  20. Effect of 0.4% benoxinate hydrochloride on corneal sensitivity, measured using the non-contact corneal aesthesiometer (NCCA). (United States)

    Murphy, P J; Blades, K J; Patel, S


    The Non-Contact Corneal Aesthesiometer (NCCA) was used to monitor the effect of topical anesthesia on corneal sensitivity loss and recovery. In a single masked randomized study, one drop of nonpreserved 0.4% benoxinate hydrochloride was instilled in either the right, left, or both eyes of 20 subjects on separate days, and measurements were made of the central corneal sensitivity in the right eye over a 60-min period. As controls, 10 subjects were retested, without any anesthetic instillation, over the same time period. No significant differences were found between these two benoxinate treatments, nor between the contralateral treatment and controls. Results indicate that there is no contralateral effect of benoxinate anesthesia, and that full recovery does not occur until 60 min after instillation. No effect on the depth and duration of anesthesia was found for iris color.

  1. Saturn's Rings and Associated Ring Plasma Cavity: Evidence for Slow Ring Erosion (United States)

    Farrell, W. M.; Kurth, W. S.; Gurnett, D. A.; Persoon, A. M.; MacDowall, R. J.


    We re-examine the radio and plasma wave observations obtained during the Cassini Saturn orbit insertion period, as the spacecraft flew over the northern ring surface into a radial distance of 1.3 Rs (over the C-ring). Voyager era studies suggest the rings are a source of micro-meteoroid generated plasma and dust, with theorized peak impact-created plasma outflows over the densest portion of the rings (central B-ring). In sharp contrast, the Cassini Radio and Plasma Wave System (RPWS) observations identify the presence of a ring-plasma cavity located in the central portion of the B-ring, with little evidence of impact-related plasma. While previous Voyager era studies have predicted unstable ion orbits over the C- ring, leading to field-aligned plasma transport to Saturns ionosphere, the Cassini RPWS observations do not reveal evidence for such instability-created plasma fountains. Given the passive ring loss processes observed by Cassini, we find that the ring lifetimes should extend >10(exp 9) years, and that there is limited evidence for prompt destruction (loss in <100 Myrs).

  2. Nationwide reduction in the number of corneal transplantations for keratoconus following the implementation of cross-linking

    NARCIS (Netherlands)

    Godefrooij, Daniel A; Gans, Renze; Imhof, Saskia M; Wisse, Robert P L


    PURPOSE: Keratoconus is characterized by corneal ectasia and irregular astigmatism, which can lead to diminished vision and corneal scarring. Approximately 10-20% of patients with keratoconus eventually require a corneal transplant. Corneal cross-linking (CXL) is a relatively new treatment that may

  3. Caustic rings of dark matter

    International Nuclear Information System (INIS)

    Sikivie, P.


    It is shown that the infall of collisionless dark matter onto isolated galaxies produce a series of caustic rings in the halo dark matter distribution. The properties of these caustics are investigated. It is found in particular that the density profile of the caustic behaves as the inverse distance to the ring. Bumps in the rotation curve of NGC 3198 are interpreted as due to caustic rings of dark matter

  4. Acute corneal edema without epithelium compromise. A case report and literature review

    Directory of Open Access Journals (Sweden)

    José Augusto Urrego-Díaz


    Full Text Available Acute corneal edema is caused by various factors, with different levels of severity, and various forms of presentation. This paper reports the case of a male patient presenting with acute corneal edema without epithelium compromise, whose clinical picture, ophthalmological examination and additional tests did not reveal its etiology. Also, a review of available literature was conducted looking for all known causes of acute corneal edema, which are classified according to the etiology of the corneal edema into injury or inflammation of the corneal epithelium or stroma, endothelial dysfunction or increase in intraocular pressure.

  5. Corneal Collagen Cross-linking for the Treatment of Progressive Corneal Ectasia: 6-Year Prospective Outcome in a French Population. (United States)

    Poli, Muriel; Lefevre, Amélie; Auxenfans, Céline; Burillon, Carole


    To evaluate 6-year results of standardized epithelium-off corneal collagen cross-linking (CXL) for treatment of progressive corneal ectasia. Prospective, consecutive, interventional case series. Thirty-six eyes of 25 consecutive patients with documented progressive primary or iatrogenic corneal ectasia underwent CXL following the Siena protocol. The main outcome measures included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, biomicroscopy and fundus appearance, topography-derived steep and flat keratometry (Kmax, Kmin), central corneal thickness (CCT), intraocular pressure with Goldmann applanation tonometer (GAT-IOP), and endothelial cell density (ECD), recorded at baseline and months 1, 3, 6, 12, 24, 36, and 72. Bilateral macular optical coherence tomography was performed at the endpoint visit. The mean follow-up was 66 ± 6 months (range, 60-78 months). At 6 years, CXL stabilized primary and iatrogenic corneal ectasia in 89% of the patients. In bilateral CXL, the progression of the first eye was highly predictive of the fellow eye's outcome. At the endpoint follow-up, the mean outcome variations were: UDVA: -0.08 ± 0.36 logMAR (P = .2); CDVA: -0.14 ± 0.28 logMAR (P = .004); Kmax: +0.11 ± 1.70 diopters (D) (P = .7); Kmin: -0.25 ± 1.25 D (P = .2); CCT: -16.38 ± 37 μm (P = .01); GAT-IOP: +1.0 ± 2.3 mm Hg (P = .01); ECD: +31 ± 400 cells/mm(2) (P = .6); no cases of macular toxicity or severe adverse events were reported. At 6 years, CXL maintains long-term results in halting the progression of corneal ectasia, with significant improvement in CDVA and long-term stability of keratometry. Further clinical studies with longer follow-up and larger series would be necessary to definitely confirm these results. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Corneal collagen crosslinking for keratoconus and corneal ectasia: One-year results. (United States)

    Hersh, Peter S; Greenstein, Steven A; Fry, Kristen L


    To evaluate 1-year outcomes of corneal collagen crosslinking (CXL) for treatment of keratoconus and corneal ectasia. Cornea and refractive surgery subspecialty practice. Prospective randomized controlled clinical trial. Collagen crosslinking was performed in eyes with keratoconus or ectasia. The treatment group received standard CXL and the sham control group received riboflavin alone. Principal outcomes included uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, astigmatism, and topography-derived outcomes of maximum and average keratometry (K) value. The UDVA improved significantly from 0.84 logMAR ± 0.34 (SD) (20/137) to 0.77 ± 0.37 logMAR (20/117) (P = .04) and the CDVA, from 0.35 ± 0.24 logMAR (20/45) to 0.23 ± 0.21 logMAR (20/34) (Pectasia subgroup, respectively. The maximum K value decreased by 2.0 D or more in 22 patients (31.0%) and increased by 2.0 D or more in 3 patients (4.2%). Collagen crosslinking was effective in improving UDVA, CDVA, the maximum K value, and the average K value. Keratoconus patients had more improvement in topographic measurements than patients with ectasia. Both CDVA and maximum K value worsened between baseline and 1 month, followed by improvement between 1, 3, and 6 months and stabilization thereafter. No author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. One-year follow-up of corneal confocal microscopy after corneal cross-linking in patients with post laser in situ keratosmileusis ectasia and keratoconus. (United States)

    Kymionis, George D; Diakonis, Vasilios F; Kalyvianaki, Maria; Portaliou, Dimitra; Siganos, Charalampos; Kozobolis, Vasilios P; Pallikaris, Aristophanis I


    To investigate corneal tissue alterations after corneal collagen cross-linking in patients with post laser in situ keratosmileusis (LASIK) keratectasia and keratoconus. Prospective comparative case series. Five patients (5 eyes) with iatrogenic keratectasia after LASIK and 5 patients (5 eyes) with progressive keratoconus were included. All eyes underwent corneal cross-linking and were assessed by corneal in vivo confocal microscopy. Three normal/healthy and 3 post-LASIK without ectasia corneas were also examined as controls. All corneas revealed normal epithelial thickness before and after surgery. Images of both keratoconic and post-LASIK corneal ectasia eyes revealed similar morphologic alterations. The subepithelial nerve plexus was absent immediately after treatment; regeneration of nerves was evident after the third postoperative month. Keratocytes were absent from the anterior 300 mum of the stroma in the first 3 months while the posterior stromal density of keratocytes was increased. Corneal collagen fibers in the anterior stroma were distributed unevenly in a net-like formation. Full-thickness keratocyte repopulation in the anterior and mid-corneal stroma was detected 6 months after treatment. The corneal endothelium did not undergo any significant changes, since the cell density and hexagonality was not found altered during the follow-up period. Keratocyte nuclei apoptosis in the anterior and intermediate corneal stroma along with collagen alterations were observed during the first 3 postcorneal cross-linking months. Gradual keratocyte repopulation was demonstrated over the following months. Corneal alterations after corneal cross-linking were similar in both keratoconic and post-LASIK corneal ectasia eyes.

  8. Acceleration of magnetized plasma rings

    International Nuclear Information System (INIS)

    Hartman, D.; Eddleman, J.; Hammer, J.H.


    One scheme is considered, acceleration of a ring between coaxial electrodes by a B/sub theta/ field as in a coaxial rail-gun. If the electrodes are conical, a ring accelerated towards the apex of the cone undergoes self-similar compression (focussing) during acceleration. Because the allowable acceleration force F/sub a/ = kappa U/sub m//R (kappa - 2 , the accelerating distance for conical electrodes is considerably shortened over that required for coaxial electrodes. In either case however, since the accelerating flux can expand as the ring moves, most of the accelerating field energy can be converted into kinetic energy of the ring leading to high efficiency

  9. Saturn's Rings Edge-on (United States)


    In one of nature's most dramatic examples of 'now-you see-them, now-you-don't', NASA's Hubble Space Telescope captured Saturn on May 22, 1995 as the planet's magnificent ring system turned edge-on. This ring-plane crossing occurs approximately every 15 years when the Earth passes through Saturn's ring plane.For comparison, the top picture was taken by Hubble on December 1, 1994 and shows the rings in a more familiar configuration for Earth observers.The bottom picture was taken shortly before the ring plane crossing. The rings do not disappear completely because the edge of the rings reflects sunlight. The dark band across the middle of Saturn is the shadow of the rings cast on the planet (the Sun is almost 3 degrees above the ring plane.) The bright stripe directly above the ring shadow is caused by sunlight reflected off the rings onto Saturn's atmosphere. Two of Saturn's icy moons are visible as tiny starlike objects in or near the ring plane. They are, from left to right, Tethys (slightly above the ring plane) and Dione.This observation will be used to determine the time of ring-plane crossing and the thickness of the main rings and to search for as yet undiscovered satellites. Knowledge of the exact time of ring-plane crossing will lead to an improved determination of the rate at which Saturn 'wobbles' about its axis (polar precession).Both pictures were taken with Hubble's Wide Field Planetary Camera 2. The top image was taken in visible light. Saturn's disk appears different in the bottom image because a narrowband filter (which only lets through light that is not absorbed by methane gas in Saturn's atmosphere) was used to reduce the bright glare of the planet. Though Saturn is approximately 900 million miles away, Hubble can see details as small as 450 miles across.The Wide Field/Planetary Camera 2 was developed by the Jet Propulsion Laboratory and managed by the Goddard Spaced Flight Center for NASA's Office of Space Science.This image and other images and

  10. Integrated Ring Resonators The Compendium

    CERN Document Server

    Rabus, Dominik G


    The optical filter, which has emerged in the last few years in integrated optics, is resonator based. Ring-resonator filters do not require facets or gratings for optical feedback and are thus particularly suited for monolithic integration with other components. Ring resonators find applications not only in optical networks, but also as sensors. The required passband shape of ring resonator-filters can be custom designed by the use of configurations of various ring coupled resonators. This book describes the current state-of-the-art on these devices with respect to design, fabrication and application.

  11. ring og refleksion

    DEFF Research Database (Denmark)

    Wahlgren, B.; Rattleff, Pernille; Høyrup, S.

    State of the art inden for forskning om læring på arbejdspladsen samt gennemgang af læringsteori og refleksionsbegrebet hos Dewey, Dreyfus, Schön, Argyris, Kolb, Jarvis, Mezirow og Brookfield. Afsluttes med diskussion af syntetiseret model for læring på arbejdspladsen.......State of the art inden for forskning om læring på arbejdspladsen samt gennemgang af læringsteori og refleksionsbegrebet hos Dewey, Dreyfus, Schön, Argyris, Kolb, Jarvis, Mezirow og Brookfield. Afsluttes med diskussion af syntetiseret model for læring på arbejdspladsen....

  12. Corneal biomechanical properties after femtosecond laser assisted LASIK with the corneal visualization Scheimpflug technology and ocular response analyzer

    Directory of Open Access Journals (Sweden)

    Jing Li


    Full Text Available AIM: To investigate the changes of corneal biomechanical properties before and after femtosecond laser assisted LASIK(FS-LASIKusing Corneal Visualisation Scheimpflug Technology(Corvis STand Ocular Response Analyzer(ORA, and the correlation with other myopic parameters. METHODS:Sixty three patients(63 eyeswho had myopic femtosecond laser assisted LASIK(FS-LASIKwere enrolled in the study. The right eye of each patient was analyzed in this study. The corneal biomechanical parameters pre-operative and 1mo post-operative was measured with the Corvis ST(Oculus, Wetzlar, Germanyand ORA(Reichert, Buffalo, New York, USA. Comparison of the biomechanical property values before and after surgery was peformed using Paired t-test or Mann-Whitney U. Pearson or Spearman correlations were used to evaluate the relationship between parameters.RESULTS: The postoperative 1st A-time, Vin, 2nd A length, Vout, HC time and Radius demonstrate significant decreases comparing with preoperative values(P=0.00, P=0.00, P=0.00, P=0.00, P=0.00, P=0.00 respectively. The postoperative 2nd A-time, DA and PD significantly increases(P=0.00, P=0.00, P=0.00, however, the 1st A length had no significant difference after surgery. The CH and CRF were significantly lower after FS-LASIK(P=0.00, P=0.00. A statistically significant correlation coefficient was found between preoperative central corneal thickness(CCTwith postoperative-preoperative changes of 1st A-time, 2nd A-time, DA and Radius respectively(P=0.01, P=0.04, P=0.03, P=0.01. CONCLUSION:There were significantly changes of corneal biomechanical properties after FS-LASIK surgery. The changes of corneal biomechanical properties after FS-LASIK can be reflected by some parameters of Corvis ST and ORA. The mainly influence of corneal biomechanical alteration was possibly correlation with corneal thickness.

  13. Severe microbial keratitis and associated perforation after corneal crosslinking for keratoconus. (United States)

    Rana, M; Lau, A; Aralikatti, A; Shah, S


    To report two cases of microbial keratitis with subsequent corneal perforation immediately following corneal collagen crosslinking (CXL). Retrospective case note review. First case was a 19 year old female presented with staphylococcal corneal abscess 3 days post CXL procedure. Corneal perforation occurred during hospital admission and was successfully treated with corneal gluing. Microbial keratitis eventually resolved, with both topical and systemic antibiotics therapy, resulting in a vascularized corneal scar. Second case was an 18 year old male whom developed Methicillin Resistant Staphylococcus aureus (MRSA) corneal abscess 5 days after CXL procedure for progressive keratoconus. Corneal perforation occurred 48 h after presentation and patient underwent uneventful corneal gluing. Although infective keratitis was successfully treated with topical therapy, patient had visual outcome of count fingers due to scarring. CXL has been widely used in the treatment of corneal ectatic conditions and complications, such as infective keratitis, are uncommon post procedure. We present two cases of severe microbial keratitis with subsequent corneal perforation within 7 days of CXL. The exact mechanism for the accelerated keratolysis process is unclear. Nonetheless, patients should be well-informed of such potentially devastating complication. Copyright © 2014. Published by Elsevier Ltd.

  14. Imaging of the Corneal Subbasal Whorl-like Nerve Plexus: More Accurate Depiction of the Extent of Corneal Nerve Damage in Patients With Diabetes. (United States)

    Utsunomiya, Tsugiaki; Nagaoka, Taiji; Hanada, Kazuomi; Omae, Tsuneaki; Yokota, Harumasa; Abiko, Atsuko; Haneda, Masakazu; Yoshida, Akitoshi


    To show that noninvasive in vivo corneal confocal microscopy (IVCM) can make more accurate imaging of the corneal subbasal nerve plexus possible. This diagnostic technique monitors the status of diabetic peripheral neuropathy. However, it is difficult to accurately confirm the corneal area captured by IVCM, which can induce measurement errors. Because the whorl-like characteristic pattern of the corneal subbasal nerve plexus is in the inferocentral cornea, we evaluated whether IVCM images of the whorl-like patterns can accurately evaluate the corneal nerve fibers in diabetic neuropathy. Forty-seven patients with diabetes (DM group) and 21 healthy control subjects underwent IVCM examination to compare the characteristics of the corneal subbasal nerve plexus around the central cornea (conventional method) and the whorl-like pattern in the inferocentral cornea (study method). We measured the total corneal nerve fiber and branch length (CNFL). The total CNFL were significantly shorter in the DM group than in the control group and tended to decrease with progression of diabetic retinopathy, nephropathy, neuropathy, and decreased corneal sensation. There was a significant positive correlation between the CNFL values obtained with the conventional method and those obtained with the study method. The coefficient of variation of the CNFL values in the study method was significantly smaller than in the conventional method. Our findings indicated that IVCM measurements of the whorl-like patterns may accurately define the extent of corneal nerve damage in order to monitor diabetic peripheral neuropathy.

  15. Automated boundary segmentation and wound analysis for longitudinal corneal OCT images (United States)

    Wang, Fei; Shi, Fei; Zhu, Weifang; Pan, Lingjiao; Chen, Haoyu; Huang, Haifan; Zheng, Kangkeng; Chen, Xinjian


    Optical coherence tomography (OCT) has been widely applied in the examination and diagnosis of corneal diseases, but the information directly achieved from the OCT images by manual inspection is limited. We propose an automatic processing method to assist ophthalmologists in locating the boundaries in corneal OCT images and analyzing the recovery of corneal wounds after treatment from longitudinal OCT images. It includes the following steps: preprocessing, epithelium and endothelium boundary segmentation and correction, wound detection, corneal boundary fitting and wound analysis. The method was tested on a data set with longitudinal corneal OCT images from 20 subjects. Each subject has five images acquired after corneal operation over a period of time. The segmentation and classification accuracy of the proposed algorithm is high and can be used for analyzing wound recovery after corneal surgery.

  16. [Expression and function of receptors for advanced glycation end products in bovine corneal endothelial cells]. (United States)

    Kaji, Yuichi


    Corneal endothelial cell loss is a change that occurs with age, but its mechanism is still unclear. We postulated that interaction between advanced glycation end product(AGE) and its receptors is implicated in the corneal endothelial cell loss with age. We investigated the expression of AGE receptors: receptors for AGE(RAGE) and galectin-3 in bovine corneal endothelial cells by reverse transcription-polymerase chain reaction(RT-PCR) and immunohistochemistry. In addition, we investigated the effect of AGE on the cultured corneal endothelial cells. Expression of RAGE and galectin-3 was detected in bovine corneal endothelial cells. Galectin-3 was important in the internalization of AGE. In contrast, RAGE was important in the generation of reactive oxygen species and induction of apoptosis. Based on these data, the interaction of AGE in aqueous humor and AGE receptors expressed on the corneal endothelial cells was speculated to have a role in the corneal endothelial cell loss with age.

  17. Interaction of ultraviolet light with the cornea: clinical implications for corneal crosslinking. (United States)

    Lombardo, Marco; Pucci, Giuseppe; Barberi, Riccardo; Lombardo, Giuseppe


    Understanding ultraviolet (UV) interaction with the human corneal tissue is of interest among corneal specialists given the widespread application of corneal crosslinking. This article reviews the current knowledge of light interaction with the cornea in the UV wavelength range. It also uses a novel experimental study to illustrate the role of 2 important corneal properties that have not yet been clarified: the epithelial contribution to overall UVA corneal absorbance and the regional anisotropy of UVA light transmittance. Finally, it presents the most recent insights into how different methods of UVA light irradiation and corneal soaking with riboflavin influence the outcome of corneal crosslinking. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Coiffured black rings (United States)

    Bena, Iosif; Ross, Simon F.; Warner, Nicholas P.


    We describe a new type of hair on supersymmetric black string and black ring solutions, which produces the largest known violation of black hole uniqueness, parameterized by an arbitrary function and hence an infinite number of continuous parameters. The new solutions can have non-trivial density profiles for the electric fields along the horizon, and yet have a geometry that is regular, although generically not infinitely differentiable, at the horizon. Both neutral and charged probes can cross the horizon without experiencing divergent forces. We also find restricted examples, parameterized by a few arbitrary continuous parameters, where the charge densities fluctuate but the metric does not and hence is completely differentiable. Our new class of solutions owes its existence to a mechanism reminiscent of the Q-ball: in the simplest examples the metric has more symmetry than the matter that supports it.

  19. Ring-constrained Join

    DEFF Research Database (Denmark)

    Yiu, Man Lung; Karras, Panagiotis; Mamoulis, Nikos


    We introduce a novel spatial join operator, the ring-constrained join (RCJ). Given two sets P and Q of spatial points, the result of RCJ consists of pairs (p, q) (where p ε P, q ε Q) satisfying an intuitive geometric constraint: the smallest circle enclosing p and q contains no other points in P, Q....... This new operation has important applications in decision support, e.g., placing recycling stations at fair locations between restaurants and residential complexes. Clearly, RCJ is defined based on a geometric constraint but not on distances between points. Thus, our operation is fundamentally different...... from the conventional distance joins and closest pairs problems. We are not aware of efficient processing algorithms for RCJ in the literature. A brute-force solution requires computational cost quadratic to input size and it does not scale well for large datasets. In view of this, we develop efficient...

  20. On separable extensions of group rings and quaternion rings

    Directory of Open Access Journals (Sweden)

    George Szeto


    Full Text Available The purposes of the present paper are (1 to give a necessary and sufficient condition for the uniqueness of the separable idempotent for a separable group ring extension RG(R may be a non-commutative ring, and (2 to give a full description of the set of separable idempotents for a quaternion ring extension RQ over a ring R, where Q are the usual quaternions i,j,k and multiplication and addition are defined as quaternion algebras over a field. We shall show that RG has a unique separable idempotent if and only if G is abelian, that there are more than one separable idempotents for a separable quaternion ring RQ, and that RQ is separable if and only if 2 is invertible in R.

  1. The Impact of Pterygium Excision on Corneal Astigmatism

    International Nuclear Information System (INIS)

    Khan, F. A.; Niazi, S. P. K.; Khan, D. A.


    Objective: To compare the corneal astigmatism before and after the excision of pterygium and also to determine the correlation of pterygium size with the postoperative corneal astigmatism. Study Design: Cross-sectional interventional study. Place and Duration of Study: Eye Department, Combined Military Hospital, Abbottabad, from May 2011 to March 2012. Methodology: Thirty patients underwent pterygium excision. Pre-operatively Snellen visual acuity, manifest refraction and slit lamp examination was done. The size of the pterygium was recorded in mm by projecting a horizontal slit lamp beam from the limbus to the apex. All the pterygium were equal to or greater than 2.5 mm. Keratometry was performed with an automated keratometer. Keratometric data was recorded pre-operatively and at 28 days postoperatively. Wilcoxon signed rank test was used for comparing the pre-operative and the postoperative corneal astigmatism. Spearman's rank order was calculated to observe correlation of pterygium size with the postoperative astigmatism. Results: The median (mean rank) pre-operative astigmatism of 2.25 (15.50) reduced to a median (mean rank) postoperative astigmatism of 1.30 (14.96). This decrease in the postoperative astigmatism was statistically significant (p < 0.001). There was a statistically non-significant correlation between the postoperative astigmatism and the pterygium size (rs = -0.29, p = 0.12). Conclusion: Pterygium excision caused significant reduction in corneal astigmatism. (author)

  2. Axial Length/Corneal Radius of Curvature Ratio and Refractive ...

    African Journals Online (AJOL)


    Dec 5, 2017 ... variously described as determined by the ocular biometric variables. There have been many studies on the relationship between refractive error and ocular axial length (AL), anterior chamber depth, corneal radius of curvature (CR), keratometric readings as well as other ocular biometric variables such as ...

  3. Treatment of Corneal Neovascularization Using Anti-VEGF Bevacizumab

    Directory of Open Access Journals (Sweden)

    Deli Krizova


    Full Text Available Purpose. To evaluate antiangiogenic effect of local use of bevacizumab (anti-VEGF antibody in patients with corneal neovascularization. Methods. Patients were divided into two groups. All patients suffered from some form of corneal neovascularization (NV. Patients in group A received 0.2–0.5 mL of bevacizumab solution subconjunctivally (concentration 25 mg/mL in a single dose. Group A included 28 eyes from 27. Patients in group B applied bevacizumab eye drops twice daily (concentration 2.5 mg/mL for two weeks. Group B included 38 eyes from 35 patients. We evaluated the number of corneal segments affected by NV, CDVA, and the incidence of complications and subjective complaints related to the treatment. The minimum follow-up period was six months. Results. By the 6-month follow-up, in group A the percentage reduction of the affected peripheral segments was 21.6% and of the central segments was 9.6%; in group B the percentage reduction of the central segments was 22.7% and of the central segments was 38.04%. In both groups we noticed a statistically significant reduction in the extent of NV. Conclusion. The use of bevacizumab seems to be an effective and safe method in the treatment of corneal neovascularization, either in the subconjunctival or topical application form.

  4. Scleral lens tolerance after corneal cross-linking for keratoconus

    NARCIS (Netherlands)

    Visser, Esther Simone; Soeters, Nienke; Tahzib, Nayyirih G.


    Purpose. Subjective and objective evaluation of scleral lens tolerance and fitting before and after corneal cross-linking (CXL) for progressive keratoconus. Methods. In this prospective cohort, evaluations were made of 18 unilateral eyes in patients who underwent CXL and had been wearing scleral

  5. Vignetting and Field of View with the KAMRA Corneal Inlay

    Directory of Open Access Journals (Sweden)

    Achim Langenbucher


    Full Text Available Purpose. To evaluate the effect of the KAMRA corneal inlay on the retinal image brightness in the peripheral visual field. Methods. A KAMRA inlay was “implanted” into a theoretical eye model in a corneal depth of 200 microns. Corneal radius was varied to a steep, normal, and flat (7.37, 7.77, and 8.17 mm version keeping the proportion of anterior to posterior radius constant. Pupil size was varied from 2.0 to 5.0 mm. Image brightness was determined for field angles from −70° to 70° with and without KAMRA and proportion of light attenuation was recorded. Results. In our parameter space, the attenuation in brightness ranges in between 0 and 60%. The attenuation in brightness is not affected by corneal shape. For large field angles where the incident ray bundle is passing through the peripheral cornea, brightness is not affected. For combinations of small pupil sizes (2.0 and 2.5 mm and field angles of 20–40°, up to 60% of light may be blocked with the KAMRA. Conclusion. For combinations of pupil sizes and field angles, the attenuation of image brightness reaches levels up to 60%. Our theoretical findings have to be clinically validated with detailed investigation of this vignetting effect.

  6. Vignetting and Field of View with the KAMRA Corneal Inlay (United States)

    Goebels, Susanne; Szentmáry, Nóra; Seitz, Berthold


    Purpose. To evaluate the effect of the KAMRA corneal inlay on the retinal image brightness in the peripheral visual field. Methods. A KAMRA inlay was “implanted” into a theoretical eye model in a corneal depth of 200 microns. Corneal radius was varied to a steep, normal, and flat (7.37, 7.77, and 8.17 mm) version keeping the proportion of anterior to posterior radius constant. Pupil size was varied from 2.0 to 5.0 mm. Image brightness was determined for field angles from −70° to 70° with and without KAMRA and proportion of light attenuation was recorded. Results. In our parameter space, the attenuation in brightness ranges in between 0 and 60%. The attenuation in brightness is not affected by corneal shape. For large field angles where the incident ray bundle is passing through the peripheral cornea, brightness is not affected. For combinations of small pupil sizes (2.0 and 2.5 mm) and field angles of 20–40°, up to 60% of light may be blocked with the KAMRA. Conclusion. For combinations of pupil sizes and field angles, the attenuation of image brightness reaches levels up to 60%. Our theoretical findings have to be clinically validated with detailed investigation of this vignetting effect. PMID:24324954

  7. Genetics Home Reference: lattice corneal dystrophy type II (United States)

    ... network of protein filaments that gives structure to cells (the cytoskeleton). Mutations that cause lattice corneal dystrophy type II change a single protein building block (amino acid) in the gelsolin protein. ... from the cell. These protein fragments clump together and form amyloid ...

  8. Acute hydrops with corneal perforation in post-LASIK ectasia. (United States)

    Gupta, Chirag; Tanaka, Thais Shiota; Elner, Victor M; Soong, H Kaz


    To report a case of corneal hydrops with perforation in a patient with ectasia after undergoing laser in situ keratomileusis (LASIK). An observational study with clinical, optical coherence tomographic, and histopathologic findings. A 41-year-old woman had an acute onset of blurry vision, pain, photophobia, tearing, and foreign body sensation in the right eye 10 years after undergoing unilateral LASIK in Jordan. According to her, the surgeon elected not to operate on the left eye because of a "corneal abnormality." On slit-lamp examination, a tear in Descemet membrane with a stromal cleft extending to the overlying LASIK flap interface was noted. The flap was partially dehisced by a diffuse channel of aqueous humor draining from the cleft and streaming out the temporal flap edge. When leakage failed to stop after 2 weeks of treatment with a bandage contact lens, the patient underwent penetrating keratoplasty. Histopathological examination of the host button showed a fluid-filled cleft connecting the flap interface. Slit-lamp examination and corneal topography of the contralateral left eye were consistent with keratoconus. Corneal hydrops with perforation in the setting of post-LASIK ectasia is extremely rare and may be associated with flap dehiscence requiring penetrating keratoplasty.

  9. Electrothermal technique for the alteration of corneal curvature

    Energy Technology Data Exchange (ETDEWEB)

    Doss, J.D.; Hutson, R.L.; Albillar, J.I.


    Extreme cases of refractive error, such as those caused by keratoconus, are often not correctable by the addition of external refraction. In such cases, corneal transplant is the usual remedy. Alternatives have recently included modification of the corneal shape by thermal techniques which exploit the dramatic shrinkage of corneal collagen at temperatures of 55 to 63/sup 0/C. The use of conventional thermal techniques has been limited by damage to the epithelium and Bowman's membrane, and by the observation that the change in corneal shape is often temporary. Each of these problems appears to be related to the thermal dose profile that is generated by the conductive heating method; temperature is relatively high in the epithelium, but is below the critical shrinkage temperature in the deeper stromal collagen. A wide variability in treatment results has also been reported; this may be due to unintentional variation in technique, especially in timing the treatment. An alternative heating technique will be discussed that has a more desirable thermal dose distribution. In addition, the technique allows precise electronic control of treatment duration, and other parameters that affect thermal dose to the cornea.

  10. Corneal eccentricity as a tool for the diagnosis of keratoconus

    NARCIS (Netherlands)

    Dao, C. L.; Kok, J. H.; Brinkman, C. J.; van Mil, C. J.


    Ninety-nine eyes with keratoconus of 64 patients were examined using the sagittal radii method to determine the corneal flattening and compared with 100 eyes of 50 healthy controls. To express the degree of this flattening, four numerical eccentricity (E) values for each eye were calculated. The

  11. Rubeola keratitis: a photographic study of corneal lesions. (United States)

    Pavlopoulos, Georgios P; Giannakos, Georgios I; Theodosiadis, Panagiotis G; Moschos, Marilita M; Iliakis, Evangelos K; Theodosiadis, Georgios P


    Detailed description of the morphology of rubeola keratitis lesions is missing from textbooks and published reports. We performed a detailed analysis of rubeola keratitis lesions by using a photographic slit lamp and ophthalmic dyes. Thirty-four eyes of 17 male young adult patients with rubeola keratitis were examined. Patients were examined at 3.6 days after the development of rash. Ocular symptoms were recorded, and patients underwent complete ocular examination including photography of corneal lesions, with and without instillation of ophthalmic dyes (rose Bengal and fluorescein). Patients complained of foreign-body sensation (88%), photophobia (65%), tearing (65%), and burning sensation (47%). Visual acuity was unaffected (26%) or mildly affected (71%). Conjunctivitis was observed in 74% and keratitis in 100% of eyes. Corneal photographs were studied, and 4 types of corneal lesions were identified: small, punctate epithelial lesions staining only with rose Bengal (100%); small, round, or larger and irregular when they coalesced epithelial defects (100%); large or tiny filaments (39%); and target lesions (100%). Target lesions appeared when both dyes were instilled. The outline of target lesions stained with rose Bengal, and they consisted of a pattern of alternating concentric zones of staining with rose Bengal and fluorescein. Keratitis was strictly confined to the epithelium and resolved gradually in all patients without the appearance of complications. Rubeola keratitis in healthy young adults runs a benign course. Recognition of the specific to rubeola keratitis corneal target lesions could aid in the differential diagnosis and prevent the transmission of the disease.

  12. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    Purpose: To determine the intra-session and inter-session reproducibility of corneal, macular and retinal nerve fiber layer thickness (RNFL) measurements with the iVue-100 optical coherence tomography in normal eyes. Methods: These parameters were measured in the right eyes of 50 healthy participants with normal ...

  13. Corneal ulcers: For the general practitioner | Ballim | Continuing ...

    African Journals Online (AJOL)

    Corneal ulcers: For the general practitioner. S Ballim. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  14. Medicinal management of corneal opacity in free ranging rhesus ...

    African Journals Online (AJOL)

    Corneal opacification was diagnosed in 17 free ranging rhesus macaques during detailed ophthalmic examination as a part of clinical health examination, at the monkey rescue sterilization centre in Hamirpur Himachal Pradesh, India. The cornea was completely opaque permitting only a little vision with respect to the ...

  15. Axial Length/Corneal Radius of Curvature Ratio and Refractive ...

    African Journals Online (AJOL)


    Feb 7, 2018 ... Aim/Background: Associations between axial length (AL) to corneal radius of curvature (CR) ratio and refractive status in a healthy Nigerian adult population were studied. Materials and Methods: Healthy students and members of staff of Obafemi Awolowo Teaching Hospitals Complex, Ile-Ife, South West ...

  16. Corneal Transplants - an overview with an emphasis on legal ...

    African Journals Online (AJOL)

    A healthy cornea is an essential component of clear vision. Any condition that distorts the clarity of the cornea to a greater extent has to be treated by keratoplasty. This article discusses by large about the various aspects of corneal transplants like modes of storage and their legal aspects with an emphasis on the scenario in ...

  17. An environmental Sporothrix as a cause of corneal ulcer


    Morrison, Annie S.; Lockhart, Shawn R.; Bromley, Jennifer G.; Kim, Joung Y.; Burd, Eileen M.


    In this case we introduce Sporothrix pallida, a non-pathogenic environmental Sporothrix species as a cause of infectious keratitis in a corneal transplant recipient. Human infections caused by S. schenckii are well-known but human infection with Sporothrix pallida has not been previously reported.

  18. CASE REPORT - Maxillary Herpes Zoster with Corneal Involvement ...

    African Journals Online (AJOL)

    Corneal involvement in maxillary herpes zoster is very rare. This report presents the case of a 32 years old 7 months pregnant para2+1 female, who presented with vesiculopapular rashes with hyperpigmented crusts over the maxillary area of the face on the left side with periocular oedema, conjunctivitis and mild punctate ...

  19. Lipid corneal degeneration after trabeculectomy with mitomicin 0.02%

    Directory of Open Access Journals (Sweden)

    Larissa Rossana Souza Stival

    Full Text Available ABSTRACT One patient with a history of trabeculectomy with Mitomicin C 0.02%, but no history of systemic disorders, exhibited unilateral corneal lipid infiltrates, together with deep stromal vascularization. She was treated with a bevacizumab injection and penetrating keratoplasty. No sign of recurrence was noted after one year post-operative.

  20. Reproducibility of corneal, macular and retinal nerve fiber layer ...

    African Journals Online (AJOL)

    in determining the utility of a device used for clinical and research purposes.2 The aim of this study was therefore to determine the reproducibility of corneal, macular and. RNFL thickness measurements in normal eyes using the. iVue-100 SD-OCT. Subjects and methods. The study was approved by the University of KwaZu-.